How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,514 to $19,498Professionalmedian $1,000 · 10th to 90th $708 to $1,514
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 $794.33 Median $5,011.87 Typical High $17,782.79 | Facility | None | $794.33 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $891.25 | Professional | None | $724.44 | $794.33 | $891.25 |
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 $707.95 Median $1,071.52 Typical High $1,380.38 | Professional | None | $707.95 | $1,071.52 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $114.82 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $151.36 Typical High $199.53 | Professional | AS · PA/NP assist | $100.00 | $151.36 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $6,025.60 | Facility | None | $851.14 | $851.14 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $6,456.54 Typical High $10,715.19 | Facility | None | $1,230.27 | $6,456.54 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $5,370.32 | Professional | None | $851.14 | $1,023.29 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,606.93 Typical High $11,220.18 | Facility | None | $2,089.30 | $6,606.93 | $11,220.18 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,737.80 | Professional | None | $851.14 | $1,202.26 | $1,737.80 |
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 $707.95 Median $891.25 Typical High $1,548.82 | Professional | None | $707.95 | $891.25 | $1,548.82 |
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 $354.81 Median $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $588.84 |
Where Indiana sits
The same service costs 17.8 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
$1,072
AK $3,388TX $191
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.