How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,122 to $14,125Professionalmedian $1,259 · 10th to 90th $933 to $2,188
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 $14,125.38 | Facility | None | $1,288.25 | $5,011.87 | $14,125.38 |
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 $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,479.11 | Professional | None | $912.01 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $263.03 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $208.93 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $3,235.94 | Facility | None | $1,380.38 | $1,380.38 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,187.76 Typical High $3,467.37 | Facility | None | $794.33 | $2,187.76 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $6,606.93 | Professional | None | $1,258.93 | $1,479.11 | $6,606.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $4,677.35 | Facility | None | $912.01 | $3,388.44 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,258.93 | $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 $1,071.52 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,380.38 | $2,344.23 |
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 $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $208.93 |
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 $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $977.24 |
Where Indiana sits
The same service costs 7.9 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· 42nd of 51
$1,318
AK $5,623TX $708
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.