How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,288 to $19,055Professionalmedian $1,413 · 10th to 90th $977 to $2,042
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 $1,148.15 Median $3,467.37 Typical High $16,595.87 | Facility | None | $1,148.15 | $3,467.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,445.44 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,513.56 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,778.28 | Professional | None | $933.25 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $204.17 Typical High $316.23 | Professional | 80 · Assistant surgeon | $151.36 | $204.17 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $177.83 Typical High $251.19 | Professional | AS · PA/NP assist | $131.83 | $177.83 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $6,025.60 | Facility | None | $1,202.26 | $1,202.26 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $6,456.54 | Facility | None | $912.01 | $3,630.78 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,445.44 | $1,995.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,479.11 | $2,630.27 |
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 $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $1,000.00 | $1,071.52 |
Where Indiana sits
The same service costs 5.2 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· 47th of 51
$1,413
AK $6,026TX $1,148
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.