How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,585 to $21,380Professionalmedian $1,479 · 10th to 90th $1,072 to $2,138
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 $16,595.87 | Facility | None | $1,230.27 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,659.59 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,187.76 Typical High $2,884.03 | Professional | 50 · Both sides | $1,584.89 | $2,187.76 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $933.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $676.08 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $234.42 Typical High $331.13 | Professional | 80 · Assistant surgeon | $169.82 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $204.17 Typical High $269.15 | Professional | AS · PA/NP assist | $147.91 | $204.17 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $7,413.10 | Facility | None | $1,318.26 | $1,318.26 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,513.56 | $2,691.53 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $7,079.46 Typical High $9,549.93 | Facility | None | $2,089.30 | $7,079.46 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,905.46 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,786.30 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,786.30 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,445.44 | $2,454.71 |
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 $616.60 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | 53 · Discontinued | $245.47 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,023.29 |
Where Indiana sits
The same service costs 8.3 times more in Wyoming 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
$1,479
WY $5,623UT $676
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.