How much rates vary
Facilitymedian $3,802 · 10th to 90th $912 to $14,454Professionalmedian $891 · 10th to 90th $562 to $1,585
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 $977.24 Median $5,011.87 Typical High $16,595.87 | Facility | None | $977.24 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,096.48 | Professional | None | $891.25 | $977.24 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,412.54 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $891.25 | Professional | None | $478.63 | $562.34 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $89.13 Typical High $141.25 | Professional | 80 · Assistant surgeon | $75.86 | $89.13 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $125.89 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $3,235.94 | Facility | None | $1,071.52 | $1,071.52 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,454.71 Typical High $3,801.89 | Facility | None | $891.25 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $4,677.35 | Professional | None | $812.83 | $1,071.52 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $5,248.07 | Facility | None | $954.99 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,479.11 | $2,041.74 |
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 $831.76 Median $1,023.29 Typical High $1,819.70 | Professional | None | $831.76 | $1,023.29 | $1,819.70 |
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 $446.68 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $741.31 |
Where Indiana sits
The same service costs 7.6 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· 43rd of 51
$977
AK $4,266TX $562
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.