How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,259 to $19,498Professionalmedian $2,630 · 10th to 90th $1,778 to $3,981
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 $1,819.70 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,041.74 | $2,238.72 |
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 $1,737.80 Median $2,818.38 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,818.38 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $446.68 Typical High $602.56 | Professional | 80 · Assistant surgeon | $275.42 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $398.11 Typical High $489.78 | Professional | AS · PA/NP assist | $239.88 | $398.11 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $8,317.64 | Facility | None | $645.65 | $5,011.87 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $14,454.40 | Professional | None | $2,187.76 | $2,630.27 | $14,454.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $5,495.41 Typical High $9,549.93 | Facility | None | $954.99 | $5,495.41 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $4,265.80 | Professional | None | $2,089.30 | $3,019.95 | $4,265.80 |
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 $1,778.28 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,778.28 | $2,344.23 | $3,981.07 |
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 $912.01 Median $1,023.29 Typical High $1,096.48 | Professional | 52 · Reduced service | $912.01 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | 53 · Discontinued | $363.08 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $204.17 Typical High $218.78 | Professional | 56 · Pre-op care only | $181.97 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,412.54 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,412.54 | $1,513.56 |
Where Indiana sits
The same service costs 21.9 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· 28th of 51
$2,818
AK $8,710TX $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.