How much rates vary
Facilitymedian $5,888 · 10th to 90th $692 to $25,119Professionalmedian $3,890 · 10th to 90th $2,818 to $5,623
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 $2,344.23 Median $3,548.13 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,548.13 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,235.94 | $3,548.13 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $5,370.32 | Professional | None | $2,691.53 | $3,890.45 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $630.96 Typical High $954.99 | Professional | 80 · Assistant surgeon | $426.58 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $549.54 Typical High $758.58 | Professional | AS · PA/NP assist | $371.54 | $549.54 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $4,365.16 Typical High $6,456.54 | Professional | None | $3,019.95 | $4,365.16 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $8,128.31 | Facility | None | $912.01 | $4,073.80 | $8,128.31 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,311.31 | $3,981.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $3,019.95 Median $4,365.16 Typical High $6,309.57 | Professional | None | $3,019.95 | $4,365.16 | $6,309.57 |
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 $1,621.81 Median $1,778.28 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,621.81 | $1,778.28 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $707.95 Typical High $794.33 | Professional | 53 · Discontinued | $645.65 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,691.53 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,454.71 | $2,691.53 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | 55 · Aftercare only | $489.78 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $354.81 Typical High $398.11 | Professional | 56 · Pre-op care only | $323.59 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,511.89 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,511.89 | $2,818.38 |
Where Indiana sits
The same service costs 7.1 times more in Alaska than in Arkansas. 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· 31st of 51
$3,890
AK $12,882AR $1,820
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.