How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $19,498Professionalmedian $631 · 10th to 90th $479 to $1,047
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 $602.56 Median $3,548.13 Typical High $14,125.38 | Facility | None | $602.56 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $758.58 | Professional | None | $602.56 | $630.96 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $758.58 | Professional | None | $467.74 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $91.20 Typical High $128.82 | Professional | 80 · Assistant surgeon | $77.62 | $91.20 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $79.43 Typical High $107.15 | Professional | AS · PA/NP assist | $66.07 | $79.43 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $6,025.60 | Facility | None | $616.60 | $616.60 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $776.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,318.26 | Professional | None | $501.19 | $741.31 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,348.96 | $5,495.41 | $8,709.64 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,479.11 | Professional | None | $660.69 | $1,023.29 | $1,479.11 |
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 $691.83 Typical High $1,258.93 | Professional | None | $537.03 | $691.83 | $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 $302.00 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $537.03 |
Where Indiana sits
The same service costs 6.6 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· 46th of 51
$676
AK $3,020TX $457
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.