How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,072 to $19,498Professionalmedian $1,549 · 10th to 90th $1,096 to $2,239
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 $1,230.27 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,230.27 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,230.27 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,122.02 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,584.89 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $1,000.00 Typical High $1,318.26 | Professional | 62 · Two surgeons | $691.83 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $257.04 Typical High $346.74 | Professional | 80 · Assistant surgeon | $173.78 | $257.04 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $223.87 Typical High $295.12 | Professional | AS · PA/NP assist | $151.36 | $223.87 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $6,456.54 | Facility | None | $1,348.96 | $1,348.96 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,370.32 Typical High $8,912.51 | Facility | None | $630.96 | $5,370.32 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $6,760.83 | Professional | None | $1,202.26 | $1,584.89 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $6,606.93 Typical High $10,471.29 | Facility | None | $1,445.44 | $6,606.93 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,819.70 | $2,398.83 |
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 $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,380.38 | $2,290.87 |
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 $575.44 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $933.25 |
Where Indiana sits
The same service costs 11.0 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· 35th of 51
$1,585
AK $5,370TX $490
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.