How much rates vary
Facilitymedian $3,236 · 10th to 90th $646 to $14,125Professionalmedian $871 · 10th to 90th $692 to $1,318
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 $758.58 Median $5,011.87 Typical High $7,244.36 | Facility | None | $758.58 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $831.76 | Professional | None | $691.83 | $758.58 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,148.15 | Professional | None | $691.83 | $870.96 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $138.04 Typical High $194.98 | Professional | 80 · Assistant surgeon | $109.65 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $120.23 Typical High $162.18 | Professional | AS · PA/NP assist | $95.50 | $120.23 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $3,235.94 | Facility | None | $831.76 | $831.76 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,995.26 Typical High $3,467.37 | Facility | None | $562.34 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $4,570.88 | Professional | None | $758.58 | $870.96 | $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 $724.44 Median $1,174.90 Typical High $1,659.59 | Professional | None | $724.44 | $1,174.90 | $1,659.59 |
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 $630.96 Median $794.33 Typical High $1,380.38 | Professional | None | $630.96 | $794.33 | $1,380.38 |
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 $338.84 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $588.84 |
Where Indiana sits
The same service costs 8.3 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· 37th of 51
$871
AK $3,388TX $407
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.