How much rates vary
Facilitymedian $6,166 · 10th to 90th $933 to $14,454Professionalmedian $661 · 10th to 90th $562 to $1,122
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 $660.69 Median $5,011.87 Typical High $14,125.38 | Facility | None | $660.69 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $724.44 | Professional | None | $575.44 | $660.69 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,148.15 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $870.96 | Professional | None | $537.03 | $660.69 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $151.36 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $93.33 Typical High $125.89 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,412.54 | Facility | None | $691.83 | $933.25 | $1,412.54 |
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 $588.84 Median $812.83 Typical High $3,630.78 | Professional | None | $588.84 | $812.83 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $9,549.93 | Facility | None | $912.01 | $2,187.76 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,412.54 | Professional | None | $676.08 | $1,000.00 | $1,412.54 |
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 $562.34 Median $741.31 Typical High $1,258.93 | Professional | None | $562.34 | $741.31 | $1,258.93 |
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 $288.40 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $288.40 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $501.19 |
Where Indiana sits
The same service costs 16.6 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· 44th of 51
$676
AK $2,818TX $170
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.