How much rates vary
Facilitymedian $4,365 · 10th to 90th $794 to $19,498Professionalmedian $1,349 · 10th to 90th $1,000 to $1,995
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 $1,096.48 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,096.48 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,096.48 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $10,964.78 Typical High $22,908.68 | Facility | None | $794.33 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,819.70 | Professional | None | $977.24 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $2,089.30 Typical High $2,754.23 | Professional | 50 · Both sides | $1,445.44 | $2,089.30 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $891.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $616.60 | $891.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $223.87 Typical High $309.03 | Professional | 80 · Assistant surgeon | $154.88 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $194.98 Typical High $257.04 | Professional | AS · PA/NP assist | $134.90 | $194.98 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,905.46 | Facility | None | $1,202.26 | $1,202.26 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,412.54 Typical High $2,187.76 | Facility | None | $549.54 | $1,412.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $6,918.31 | Professional | None | $1,096.48 | $1,412.54 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $3,890.45 | Facility | None | $1,445.44 | $2,398.83 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,621.81 | $2,137.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,041.74 | Professional | None | $954.99 | $1,230.27 | $2,041.74 |
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 $512.86 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $831.76 |
Where Indiana sits
The same service costs 6.2 times more in Alaska than in Utah. 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
$1,413
AK $4,786UT $776
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.