How much rates vary
Facilitymedian $7,079 · 10th to 90th $813 to $15,136Professionalmedian $1,862 · 10th to 90th $1,445 to $2,630
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 $1,659.59 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,659.59 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,698.24 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,949.84 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $316.23 Typical High $416.87 | Professional | 80 · Assistant surgeon | $234.42 | $316.23 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $275.42 Typical High $338.84 | Professional | AS · PA/NP assist | $204.17 | $275.42 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,995.26 Typical High $3,467.37 | Facility | None | $575.44 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,949.84 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,570.88 | Facility | None | $912.01 | $2,290.87 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,819.70 | $2,398.83 | $2,951.21 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,819.70 | $2,754.23 |
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 $831.76 Median $831.76 Typical High $1,148.15 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $457.09 | Professional | 53 · Discontinued | $331.13 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,621.81 |
Where Indiana sits
The same service costs 5.4 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· 33rd of 51
$1,950
AK $6,026TX $1,122
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.