How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $2,692 · 10th to 90th $2,138 to $3,981
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 $2,238.72 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,238.72 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,238.72 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,691.53 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,691.53 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $436.52 Typical High $645.65 | Professional | 80 · Assistant surgeon | $338.84 | $436.52 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $380.19 Typical High $537.03 | Professional | AS · PA/NP assist | $302.00 | $380.19 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,511.89 Typical High $4,466.84 | Facility | None | $575.44 | $2,511.89 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,951.21 | $4,073.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $6,456.54 | Facility | None | $912.01 | $3,235.94 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,630.27 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,630.27 | $3,548.13 | $4,677.35 |
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 $2,041.74 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,041.74 | $2,754.23 | $4,466.84 |
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 $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 53 · Discontinued | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $281.84 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,949.84 |
Where Indiana sits
The same service costs 17.4 times more in Alaska than in Texas. 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
$2,692
AK $10,471TX $603
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.