How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $2,692 · 10th to 90th $1,995 to $3,802
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 $2,089.30 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,089.30 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,089.30 | $2,570.40 |
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 $1,995.26 Median $2,691.53 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,691.53 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,698.24 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,258.93 | $1,698.24 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $426.58 Typical High $575.44 | Professional | 80 · Assistant surgeon | $316.23 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $371.54 Typical High $501.19 | Professional | AS · PA/NP assist | $275.42 | $371.54 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,344.23 Typical High $4,570.88 | Facility | None | $575.44 | $2,344.23 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $12,022.64 | Professional | None | $1,995.26 | $2,691.53 | $12,022.64 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,019.95 Typical High $6,025.60 | Facility | None | $912.01 | $3,019.95 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,137.96 | $3,162.28 | $4,365.16 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,454.71 Typical High $10,715.19 | Facility | None | $302.00 | $2,454.71 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,454.71 | $3,981.07 |
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 $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $512.86 | Professional | 53 · Discontinued | $416.87 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,584.89 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,548.82 | $1,584.89 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $389.05 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,479.11 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,479.11 | $1,819.70 |
Where Indiana sits
The same service costs 23.4 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
$2,692
AK $9,550TX $407
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.