How much rates vary
Facilitymedian $3,981 · 10th to 90th $741 to $14,125Professionalmedian $427 · 10th to 90th $309 to $617
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 $338.84 Median $5,011.87 Typical High $5,623.41 | Facility | None | $338.84 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | None | $338.84 | $338.84 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $575.44 | Professional | None | $302.00 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $630.96 Typical High $870.96 | Professional | 50 · Both sides | $457.09 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $67.61 Typical High $95.50 | Professional | 80 · Assistant surgeon | $47.86 | $67.61 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $58.88 Typical High $81.28 | Professional | AS · PA/NP assist | $42.66 | $58.88 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $3,467.37 | Facility | None | $354.81 | $354.81 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $3,715.35 | Facility | None | $407.38 | $2,238.72 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $724.44 | Professional | None | $331.13 | $426.58 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,311.31 Typical High $5,011.87 | Facility | None | $912.01 | $3,311.31 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $660.69 | Professional | None | $363.08 | $436.52 | $660.69 |
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 $323.59 Median $407.38 Typical High $645.65 | Professional | None | $323.59 | $407.38 | $645.65 |
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 $169.82 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $295.12 |
Where Indiana sits
The same service costs 6.9 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· 42nd of 51
$427
AK $1,905UT $275
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.