How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $19,055Professionalmedian $708 · 10th to 90th $589 to $1,047
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 $724.44 Median $5,011.87 Typical High $16,595.87 | Facility | None | $724.44 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $977.24 | Professional | None | $707.95 | $724.44 | $977.24 |
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 $575.44 Median $707.95 Typical High $794.33 | Professional | None | $575.44 | $707.95 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $147.91 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $97.72 Typical High $114.82 | Professional | AS · PA/NP assist | $81.28 | $97.72 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $6,025.60 | Facility | None | $741.31 | $741.31 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $6,456.54 | Facility | None | $812.83 | $3,630.78 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,380.38 | Professional | None | $630.96 | $794.33 | $1,380.38 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $977.24 Median $6,165.95 Typical High $8,511.38 | Facility | None | $977.24 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,288.25 | Professional | None | $794.33 | $1,023.29 | $1,288.25 |
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 $616.60 Median $776.25 Typical High $1,174.90 | Professional | None | $616.60 | $776.25 | $1,174.90 |
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 $354.81 Median $363.08 Typical High $489.78 | Professional | 52 · Reduced service | $354.81 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $724.44 | Professional | 54 · Surgery only | $537.03 | $549.54 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $97.72 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $676.08 |
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
$708
AK $3,020TX $490
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.