How much rates vary
Facilitymedian $4,467 · 10th to 90th $933 to $14,125Professionalmedian $955 · 10th to 90th $676 to $1,318
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 $11,220.18 | Facility | None | $724.44 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | None | $724.44 | $724.44 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,288.25 | Professional | None | $630.96 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $154.88 Typical High $218.78 | Professional | 80 · Assistant surgeon | $102.33 | $154.88 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $89.13 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $3,467.37 | Facility | None | $758.58 | $758.58 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $3,630.78 | Facility | None | $645.65 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $3,548.13 Typical High $5,011.87 | Facility | None | $1,513.56 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,412.54 | Professional | None | $758.58 | $933.25 | $1,412.54 |
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 $724.44 Median $891.25 Typical High $1,412.54 | Professional | None | $724.44 | $891.25 | $1,412.54 |
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 $363.08 Median $363.08 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Where Indiana sits
The same service costs 7.9 times more in Oklahoma than in Utah. 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· 36th of 51
$955
OK $4,169UT $525
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.