How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $19,055Professionalmedian $1,288 · 10th to 90th $933 to $1,862
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 $1,023.29 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,023.29 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | None | $933.25 | $1,023.29 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,698.24 | Professional | None | $891.25 | $1,318.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $831.76 Typical High $1,096.48 | Professional | 62 · Two surgeons | $562.34 | $831.76 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $213.80 Typical High $288.40 | Professional | 80 · Assistant surgeon | $141.25 | $213.80 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $186.21 Typical High $245.47 | Professional | AS · PA/NP assist | $123.03 | $186.21 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $8,128.31 | Facility | None | $1,096.48 | $1,096.48 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $5,754.40 | Facility | None | $794.33 | $3,162.28 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $6,165.95 | Professional | None | $1,071.52 | $1,318.26 | $6,165.95 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $6,918.31 Typical High $9,772.37 | Facility | None | $1,445.44 | $6,918.31 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,513.56 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,949.84 | Professional | None | $891.25 | $1,174.90 | $1,949.84 |
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 $467.74 Median $512.86 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $758.58 |
Where Indiana sits
The same service costs 6.3 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· 34th of 51
$1,318
AK $4,365UT $692
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.