How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,318 to $19,498Professionalmedian $1,905 · 10th to 90th $1,349 to $2,884
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 $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,548.82 | $1,698.24 |
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 $1,318.26 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,318.26 | $2,041.74 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $208.93 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $288.40 Typical High $371.54 | Professional | AS · PA/NP assist | $186.21 | $288.40 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $7,585.78 | Facility | None | $1,659.59 | $1,659.59 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,365.16 Typical High $8,128.31 | Facility | None | $676.08 | $4,365.16 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $10,000.00 | Professional | None | $1,584.89 | $1,905.46 | $10,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $7,762.47 Typical High $9,772.37 | Facility | None | $2,089.30 | $7,762.47 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,344.23 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,778.28 | $2,951.21 |
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 $691.83 Median $776.25 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,148.15 |
Where Indiana sits
The same service costs 20.4 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· 31st of 51
$2,042
AK $6,607TX $324
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.