How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $3,020 · 10th to 90th $2,089 to $4,169
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 $2,238.72 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,238.72 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,238.72 | $2,754.23 |
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 $2,089.30 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,089.30 | $3,162.28 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,995.26 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,318.26 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $512.86 Typical High $724.44 | Professional | 80 · Assistant surgeon | $338.84 | $512.86 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $446.68 Typical High $602.56 | Professional | AS · PA/NP assist | $295.12 | $446.68 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,454.71 Typical High $4,897.79 | Facility | None | $562.34 | $2,454.71 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,884.03 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,162.28 Typical High $6,456.54 | Facility | None | $912.01 | $3,162.28 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $4,677.35 | Professional | None | $2,570.40 | $3,467.37 | $4,677.35 |
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 $2,187.76 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,187.76 | $2,884.03 | $4,466.84 |
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 $1,096.48 Median $1,122.02 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | 53 · Discontinued | $446.68 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,949.84 |
Where Indiana sits
The same service costs 10.0 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· 27th of 51
$3,162
AK $10,233TX $1,023
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.