How much rates vary
Facilitymedian $12,303 · 10th to 90th $912 to $30,903Professionalmedian $3,020 · 10th to 90th $2,138 to $4,365
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,290.87 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,290.87 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,884.03 | Professional | None | $2,290.87 | $2,290.87 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,754.23 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $4,073.80 | Professional | None | $2,137.96 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,905.46 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,348.96 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $489.78 Typical High $691.83 | Professional | 80 · Assistant surgeon | $346.74 | $489.78 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $302.00 | $426.58 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $5,248.07 | Facility | None | $575.44 | $2,691.53 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $4,466.84 | Professional | None | $2,290.87 | $3,019.95 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $6,606.93 | Facility | None | $912.01 | $3,235.94 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,548.13 | $4,786.30 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,290.87 | $3,019.95 | $4,677.35 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 53 · Discontinued | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $346.74 Typical High $426.58 | Professional | 55 · Aftercare only | $338.84 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,995.26 |
Where Indiana sits
The same service costs 17.0 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 33rd of 51
$3,020
AK $10,471TX $617
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.