How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,288 to $19,498Professionalmedian $741 · 10th to 90th $631 to $1,202
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 $691.83 Median $5,011.87 Typical High $17,782.79 | Facility | None | $691.83 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $794.33 | Professional | None | $616.60 | $691.83 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,737.80 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $977.24 | Professional | None | $602.56 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $169.82 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $141.25 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $7,585.78 | Facility | None | $741.31 | $741.31 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $4,466.84 Typical High $6,606.93 | Facility | None | $1,122.02 | $4,466.84 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $3,890.45 | Professional | None | $676.08 | $831.76 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $6,456.54 Typical High $9,332.54 | Facility | None | $1,348.96 | $6,456.54 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,513.56 | Professional | None | $741.31 | $1,071.52 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,348.96 | Professional | None | $616.60 | $741.31 | $1,348.96 |
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 $309.03 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $524.81 |
Where Indiana sits
The same service costs 17.4 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· 42nd of 51
$759
AK $3,020TX $174
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.