How much rates vary
Facilitymedian $3,890 · 10th to 90th $912 to $9,120Professionalmedian $871 · 10th to 90th $631 to $1,230
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 $14,125.38 | Facility | None | $691.83 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,174.90 | Professional | None | $602.56 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $138.04 Typical High $199.53 | Professional | 80 · Assistant surgeon | $95.50 | $138.04 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $83.18 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,467.37 | Facility | None | $724.44 | $724.44 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,089.30 Typical High $3,630.78 | Facility | None | $724.44 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,288.25 | Professional | None | $660.69 | $870.96 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $5,011.87 | Facility | None | $1,513.56 | $3,311.31 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,318.26 | Professional | None | $724.44 | $891.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,318.26 | Professional | None | $676.08 | $851.14 | $1,318.26 |
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 $346.74 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $575.44 |
Where Indiana sits
The same service costs 5.8 times more in Alaska 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· 38th of 51
$871
AK $2,818UT $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.