How much rates vary
Facilitymedian $12,303 · 10th to 90th $912 to $30,903Professionalmedian $2,291 · 10th to 90th $1,820 to $3,388
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 $1,905.46 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,905.46 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,905.46 | $1,905.46 | $2,398.83 |
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 $1,819.70 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,290.87 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | 80 · Assistant surgeon | $288.40 | $363.08 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $316.23 Typical High $446.68 | Professional | AS · PA/NP assist | $251.19 | $316.23 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,570.40 Typical High $4,365.16 | Facility | None | $575.44 | $2,570.40 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,511.89 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,754.23 Typical High $5,495.41 | Facility | None | $912.01 | $2,754.23 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,238.72 | $2,951.21 | $3,981.07 |
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 $1,819.70 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,398.83 | $3,890.45 |
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 $954.99 Median $954.99 Typical High $1,202.26 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $478.63 | Professional | 53 · Discontinued | $380.19 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,445.44 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,445.44 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $288.40 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,348.96 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,348.96 | $1,659.59 |
Where Indiana sits
The same service costs 8.1 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· 38th of 51
$2,291
AK $8,913TX $1,096
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.