How much rates vary
Facilitymedian $8,710 · 10th to 90th $832 to $19,498Professionalmedian $1,230 · 10th to 90th $871 to $1,778
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 $977.24 Median $5,011.87 Typical High $7,244.36 | Facility | None | $977.24 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,096.48 | Professional | None | $912.01 | $977.24 | $1,096.48 |
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 $870.96 Median $1,258.93 Typical High $1,584.89 | Professional | None | $870.96 | $1,258.93 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $794.33 Typical High $1,047.13 | Professional | 62 · Two surgeons | $549.54 | $794.33 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $141.25 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $123.03 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $9,549.93 | Facility | None | $1,071.52 | $1,071.52 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $8,511.38 Typical High $14,454.40 | Facility | None | $549.54 | $8,511.38 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $5,754.40 | Professional | None | $954.99 | $1,258.93 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $9,332.54 Typical High $14,791.08 | Facility | None | $1,445.44 | $9,332.54 | $14,791.08 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,445.44 | $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 $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | None | $851.14 | $1,122.02 | $1,819.70 |
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 $457.09 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $457.09 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $741.31 |
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· 35th of 51
$1,259
AK $4,266UT $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.