How much rates vary
Facilitymedian $13,490 · 10th to 90th $851 to $30,903Professionalmedian $1,905 · 10th to 90th $1,479 to $2,884
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 $1,513.56 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,513.56 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,513.56 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,691.53 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,202.26 Typical High $1,659.59 | Professional | 62 · Two surgeons | $933.25 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $234.42 | $309.03 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $269.15 Typical High $371.54 | Professional | AS · PA/NP assist | $204.17 | $269.15 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,041.74 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,466.84 | Facility | None | $912.01 | $2,290.87 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,398.83 | $3,235.94 |
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 $1,479.11 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,949.84 | $3,090.30 |
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 $741.31 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $741.31 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,318.26 |
Where Indiana sits
The same service costs 5.9 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· 38th of 51
$1,905
AK $6,918TX $1,175
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.