How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $14,454Professionalmedian $1,349 · 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 $1,258.93 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,258.93 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,445.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,995.26 Typical High $2,691.53 | Professional | 50 · Both sides | $1,621.81 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $851.14 Typical High $1,148.15 | Professional | 62 · Two surgeons | $676.08 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $213.80 Typical High $316.23 | Professional | 80 · Assistant surgeon | $173.78 | $213.80 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $186.21 Typical High $251.19 | Professional | AS · PA/NP assist | $151.36 | $186.21 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $4,168.69 | Facility | None | $1,318.26 | $1,318.26 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,691.53 Typical High $4,570.88 | Facility | None | $912.01 | $2,691.53 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,089.30 | Professional | None | $831.76 | $1,380.38 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,905.46 Median $3,801.89 Typical High $5,623.41 | Facility | None | $1,905.46 | $3,801.89 | $5,623.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,949.84 | $2,398.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,047.13 | $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 $630.96 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,047.13 |
Where Indiana sits
The same service costs 7.1 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· 40th of 51
$1,380
AK $5,370UT $759
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.