How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,380 to $19,498Professionalmedian $741 · 10th to 90th $537 to $1,148
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 $588.84 Median $3,467.37 Typical High $16,595.87 | Facility | None | $588.84 | $3,467.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $794.33 | Professional | None | $588.84 | $707.95 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,513.56 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $933.25 | Professional | None | $512.86 | $741.31 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $120.23 Typical High $162.18 | Professional | 80 · Assistant surgeon | $83.18 | $120.23 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $104.71 Typical High $138.04 | Professional | AS · PA/NP assist | $72.44 | $104.71 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $6,025.60 | Facility | None | $602.56 | $602.56 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $891.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,445.44 | Professional | None | $549.54 | $776.25 | $1,445.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,548.82 Median $5,128.61 Typical High $8,511.38 | Facility | None | $1,548.82 | $5,128.61 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,548.82 | Professional | None | $660.69 | $1,047.13 | $1,548.82 |
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 $537.03 Median $741.31 Typical High $1,288.25 | Professional | None | $537.03 | $741.31 | $1,288.25 |
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 $295.12 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $295.12 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $436.52 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $562.34 |
Where Indiana sits
The same service costs 6.2 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· 41st of 51
$741
AK $3,020TX $490
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.