How much rates vary
Facilitymedian $9,333 · 10th to 90th $891 to $21,380Professionalmedian $1,096 · 10th to 90th $794 to $1,549
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 $912.01 Median $5,011.87 Typical High $17,782.79 | Facility | None | $912.01 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,071.52 | Professional | None | $831.76 | $912.01 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,125.38 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,125.38 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,513.56 | Professional | None | $741.31 | $1,148.15 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $181.97 Typical High $257.04 | Professional | 80 · Assistant surgeon | $120.23 | $181.97 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $158.49 Typical High $213.80 | Professional | AS · PA/NP assist | $104.71 | $158.49 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,288.25 Typical High $2,691.53 | Facility | None | $562.34 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,548.82 | Professional | None | $912.01 | $1,071.52 | $1,548.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $2,398.83 | Facility | None | $912.01 | $2,089.30 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,659.59 | Professional | None | $912.01 | $1,122.02 | $1,659.59 |
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 $851.14 Median $1,047.13 Typical High $1,659.59 | Professional | None | $851.14 | $1,047.13 | $1,659.59 |
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 $407.38 Median $446.68 Typical High $537.03 | Professional | 52 · Reduced service | $407.38 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $616.60 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $162.18 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $758.58 |
Where Indiana sits
The same service costs 6.3 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· 30th of 51
$1,148
AK $3,715UT $589
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.