How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,514 to $19,498Professionalmedian $776 · 10th to 90th $603 to $1,096
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 $691.83 Median $5,011.87 Typical High $17,782.79 | Facility | None | $691.83 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $977.24 | Professional | None | $676.08 | $691.83 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,737.80 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $933.25 | Professional | None | $602.56 | $812.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $131.83 Typical High $173.78 | Professional | 80 · Assistant surgeon | $95.50 | $131.83 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $114.82 Typical High $131.83 | Professional | AS · PA/NP assist | $83.18 | $114.82 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $6,025.60 | Facility | None | $707.95 | $707.95 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $4,466.84 Typical High $6,606.93 | Facility | None | $1,230.27 | $4,466.84 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,412.54 | Professional | None | $660.69 | $812.83 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,819.70 Median $6,456.54 Typical High $9,332.54 | Facility | None | $1,819.70 | $6,456.54 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,258.93 | Professional | None | $741.31 | $1,000.00 | $1,258.93 |
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 $602.56 Median $741.31 Typical High $1,148.15 | Professional | None | $602.56 | $741.31 | $1,148.15 |
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 $346.74 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $512.86 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $645.65 |
Where Indiana sits
The same service costs 6.3 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· 34th of 51
$813
AK $2,884TX $457
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.