How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,698 to $29,512Professionalmedian $3,162 · 10th to 90th $2,291 to $4,898
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 $1,380.38 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,380.38 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,630.27 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $15,488.17 Typical High $33,884.42 | Facility | None | $2,398.83 | $15,488.17 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $4,570.88 | Professional | None | $2,290.87 | $3,630.78 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $588.84 Typical High $794.33 | Professional | 80 · Assistant surgeon | $371.54 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $512.86 Typical High $645.65 | Professional | AS · PA/NP assist | $323.59 | $512.86 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $7,244.36 | Facility | None | $2,884.03 | $2,884.03 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $4,786.30 Typical High $7,943.28 | Facility | None | $724.44 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $15,488.17 | Professional | None | $2,691.53 | $3,162.28 | $15,488.17 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $7,585.78 Typical High $10,471.29 | Facility | None | $2,089.30 | $7,585.78 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,754.23 Median $3,890.45 Typical High $5,623.41 | Professional | None | $2,754.23 | $3,890.45 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $5,011.87 | Professional | None | $2,290.87 | $2,754.23 | $5,011.87 |
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 $1,202.26 Median $1,318.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,202.26 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,949.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,819.70 | $1,949.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $389.05 Typical High $436.52 | Professional | 55 · Aftercare only | $363.08 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $263.03 Typical High $288.40 | Professional | 56 · Pre-op care only | $239.88 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,819.70 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,819.70 | $2,041.74 |
Where Indiana sits
The same service costs 19.5 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· 27th of 51
$3,467
AK $11,482TX $589
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.