How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,288 to $19,498Professionalmedian $832 · 10th to 90th $617 to $1,259
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 $630.96 Median $691.83 Typical High $776.25 | Professional | None | $630.96 | $691.83 | $776.25 |
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 $616.60 Median $870.96 Typical High $1,122.02 | Professional | None | $616.60 | $870.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $100.00 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $120.23 Typical High $158.49 | Professional | AS · PA/NP assist | $87.10 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $6,025.60 | Facility | None | $758.58 | $758.58 | $6,025.60 |
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 $724.44 Median $851.14 Typical High $4,365.16 | Professional | None | $724.44 | $851.14 | $4,365.16 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $6,165.95 Typical High $8,511.38 | Facility | None | $1,348.96 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,445.44 | Professional | None | $707.95 | $1,047.13 | $1,445.44 |
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 $602.56 Median $758.58 Typical High $1,318.26 | Professional | None | $602.56 | $758.58 | $1,318.26 |
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 $316.23 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $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 $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $524.81 |
Where Indiana sits
The same service costs 8.5 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· 33rd of 51
$871
AK $3,020TX $355
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.