How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,000Professionalmedian $933 · 10th to 90th $776 to $1,380
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 $933.25 Median $5,011.87 Typical High $16,595.87 | Facility | None | $933.25 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $5,370.32 Typical High $9,549.93 | Facility | None | $1,412.54 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,096.48 | Professional | None | $758.58 | $912.01 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $194.98 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $154.88 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $2,884.03 | Facility | None | $977.24 | $977.24 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,290.87 Typical High $3,801.89 | Facility | None | $891.25 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,819.70 | Professional | None | $912.01 | $1,071.52 | $1,819.70 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $6,025.60 | Facility | None | $1,819.70 | $2,951.21 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,318.26 | $1,737.80 |
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 $812.83 Median $1,000.00 Typical High $1,548.82 | Professional | None | $812.83 | $1,000.00 | $1,548.82 |
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 $467.74 Median $467.74 Typical High $630.96 | Professional | 52 · Reduced service | $467.74 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 53 · Discontinued | $186.21 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $933.25 | Professional | 54 · Surgery only | $691.83 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $186.21 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $870.96 |
Where Indiana sits
The same service costs 6.2 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· 45th of 51
$933
AK $3,802TX $617
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.