How much rates vary
Facilitymedian $10,471 · 10th to 90th $832 to $23,988Professionalmedian $1,318 · 10th to 90th $1,047 to $2,042
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 $1,148.15 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,148.15 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,148.15 | $1,258.93 |
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 $1,047.13 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $302.00 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $251.19 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,096.48 Median $1,445.44 Typical High $6,025.60 | Professional | None | $1,096.48 | $1,445.44 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,311.31 | Facility | None | $912.01 | $2,290.87 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,698.24 | $2,290.87 |
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 $1,023.29 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,258.93 | $2,187.76 |
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 $537.03 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $870.96 |
Where Indiana sits
The same service costs 6.5 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· 37th of 51
$1,318
AK $5,012TX $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.