How much rates vary
Facilitymedian $3,090 · 10th to 90th $617 to $14,125Professionalmedian $692 · 10th to 90th $562 to $1,072
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 $630.96 Median $5,011.87 Typical High $5,623.41 | Facility | None | $630.96 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $691.83 | Professional | None | $562.34 | $630.96 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $724.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $933.25 | Professional | None | $575.44 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $97.72 Typical High $131.83 | Professional | AS · PA/NP assist | $81.28 | $97.72 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $3,235.94 | Facility | None | $676.08 | $676.08 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,905.46 Typical High $3,467.37 | Facility | None | $426.58 | $1,905.46 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $4,570.88 | Professional | None | $660.69 | $831.76 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,348.96 | Professional | None | $575.44 | $1,000.00 | $1,348.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,122.02 | Professional | None | $512.86 | $660.69 | $1,122.02 |
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 $281.84 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $478.63 |
Where Indiana sits
The same service costs 7.8 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· 41st of 51
$692
AK $2,754TX $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.