How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $2,884 · 10th to 90th $2,042 to $4,074
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 $2,137.96 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,137.96 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,137.96 | $2,630.27 |
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 $2,041.74 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,884.03 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,819.70 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,288.25 | $1,819.70 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $457.09 Typical High $660.69 | Professional | 80 · Assistant surgeon | $331.13 | $457.09 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $407.38 Typical High $549.54 | Professional | AS · PA/NP assist | $288.40 | $407.38 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,344.23 Typical High $4,786.30 | Facility | None | $562.34 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,818.38 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,090.30 Typical High $6,165.95 | Facility | None | $912.01 | $3,090.30 | $6,165.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,388.44 | $4,466.84 |
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 $2,137.96 Median $2,691.53 Typical High $4,365.16 | Professional | None | $2,137.96 | $2,691.53 | $4,365.16 |
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 $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 53 · Discontinued | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $323.59 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,862.09 |
Where Indiana sits
The same service costs 6.0 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· 29th of 51
$2,884
AK $9,772TX $1,622
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.