How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,175 to $39,811Professionalmedian $794 · 10th to 90th $661 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 $794.33 Median $5,011.87 Typical High $16,595.87 | Facility | None | $794.33 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $954.99 | Professional | None | $724.44 | $794.33 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,258.93 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,096.48 | Professional | None | $660.69 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $190.55 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $154.88 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $10,232.93 | Facility | None | $831.76 | $831.76 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,760.83 Typical High $10,964.78 | Facility | None | $645.65 | $6,760.83 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,258.93 | Professional | None | $812.83 | $977.24 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $9,120.11 Typical High $15,135.61 | Facility | None | $954.99 | $9,120.11 | $15,135.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,479.11 | Professional | None | $794.33 | $977.24 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,548.82 | Professional | None | $776.25 | $977.24 | $1,548.82 |
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 $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $660.69 |
Where Indiana sits
The same service costs 11.0 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· 39th of 51
$955
OK $5,888UT $537
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.