How much rates vary
Facilitymedian $10,471 · 10th to 90th $832 to $23,988Professionalmedian $1,072 · 10th to 90th $776 to $1,585
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 $831.76 Median $3,467.37 Typical High $5,011.87 | Facility | None | $831.76 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $954.99 | Professional | None | $812.83 | $831.76 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $15,488.17 Typical High $25,703.96 | Facility | None | $1,862.09 | $15,488.17 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,445.44 | Professional | None | $776.25 | $1,122.02 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $707.95 Typical High $933.25 | Professional | 62 · Two surgeons | $489.78 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $177.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $125.89 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $154.88 Typical High $204.17 | Professional | AS · PA/NP assist | $109.65 | $154.88 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
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 $831.76 Median $1,096.48 Typical High $4,786.30 | Professional | None | $831.76 | $1,096.48 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $933.25 | $1,258.93 | $1,737.80 |
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 $741.31 Median $954.99 Typical High $1,584.89 | Professional | None | $741.31 | $954.99 | $1,584.89 |
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 $407.38 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $676.08 |
Where Indiana sits
The same service costs 24.0 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· 32nd of 51
$1,122
AK $3,715TX $155
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.