How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,096 to $14,125Professionalmedian $813 · 10th to 90th $661 to $1,259
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 $660.69 Median $5,011.87 Typical High $14,125.38 | Facility | None | $660.69 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | None | $660.69 | $660.69 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,202.26 | Professional | None | $630.96 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $512.86 Typical High $758.58 | Professional | 62 · Two surgeons | $398.11 | $512.86 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $204.17 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $114.82 Typical High $169.82 | Professional | AS · PA/NP assist | $89.13 | $114.82 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $4,073.80 | Facility | None | $812.83 | $812.83 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,818.38 Typical High $4,168.69 | Facility | None | $776.25 | $2,818.38 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $3,630.78 Typical High $5,248.07 | Facility | None | $1,023.29 | $3,630.78 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,380.38 | Professional | None | $676.08 | $1,000.00 | $1,380.38 |
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 $616.60 Median $794.33 Typical High $1,230.27 | Professional | None | $616.60 | $794.33 | $1,230.27 |
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 $331.13 Median $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $575.44 |
Where Indiana sits
The same service costs 8.1 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
$891
AK $3,236TX $398
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.