How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,047 to $28,840Professionalmedian $1,660 · 10th to 90th $1,202 to $2,344
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 $1,288.25 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,288.25 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,288.25 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,230.27 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $190.55 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $234.42 Typical High $309.03 | Professional | AS · PA/NP assist | $169.82 | $234.42 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $7,244.36 | Facility | None | $1,380.38 | $1,380.38 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $7,762.47 | Facility | None | $645.65 | $4,168.69 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $9,549.93 | Professional | None | $1,380.38 | $1,698.24 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $10,471.29 | Facility | None | $912.01 | $5,248.07 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,445.44 | $2,398.83 |
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 $575.44 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $281.84 | Professional | 53 · Discontinued | $229.09 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $1,000.00 |
Where Indiana sits
The same service costs 17.0 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· 33rd of 51
$1,660
AK $5,623TX $331
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.