How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,072 to $19,055Professionalmedian $759 · 10th to 90th $550 to $1,072
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 $660.69 Median $3,548.13 Typical High $14,125.38 | Facility | None | $660.69 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $933.25 | Professional | None | $660.69 | $831.76 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $10,964.78 Typical High $22,908.68 | Facility | None | $1,380.38 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $851.14 | Professional | None | $537.03 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $102.33 Typical High $144.54 | Professional | 80 · Assistant surgeon | $85.11 | $102.33 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $89.13 Typical High $120.23 | Professional | AS · PA/NP assist | $74.13 | $89.13 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $6,025.60 | Facility | None | $676.08 | $676.08 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $3,890.45 Typical High $6,606.93 | Facility | None | $776.25 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,348.96 | Professional | None | $691.83 | $831.76 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $4,466.84 Typical High $8,511.38 | Facility | None | $1,348.96 | $4,466.84 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,412.54 | Professional | None | $741.31 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
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 $331.13 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $131.83 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $588.84 | $660.69 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 44th of 51
$759
AK $2,754NJ $631
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.