How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,072 to $15,849Professionalmedian $1,622 · 10th to 90th $1,148 to $2,399
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 $16,595.87 | Facility | None | $1,288.25 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,288.25 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,698.24 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $186.21 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $234.42 Typical High $316.23 | Professional | AS · PA/NP assist | $162.18 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,025.60 Typical High $10,232.93 | Facility | None | $645.65 | $6,025.60 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $8,709.64 | Professional | None | $1,380.38 | $1,659.59 | $8,709.64 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,884.03 Typical High $11,481.54 | Facility | None | $912.01 | $2,884.03 | $11,481.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,445.44 | $2,454.71 |
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 $588.84 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,000.00 |
Where Indiana sits
The same service costs 18.6 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· 33rd of 51
$1,698
AK $5,623TX $302
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.