How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,318 to $19,498Professionalmedian $1,738 · 10th to 90th $1,413 to $2,692
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 $1,445.44 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,621.81 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $229.09 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $199.53 | $245.47 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,466.84 Typical High $8,128.31 | Facility | None | $676.08 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $8,128.31 | Professional | None | $1,445.44 | $1,905.46 | $8,128.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $4,570.88 Typical High $9,549.93 | Facility | None | $954.99 | $4,570.88 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,398.83 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,737.80 | $3,090.30 |
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 $724.44 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $162.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $144.54 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,174.90 |
Where Indiana sits
The same service costs 18.2 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· 40th of 51
$1,738
AK $6,918TX $380
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.