How much rates vary
Facilitymedian $5,495 · 10th to 90th $832 to $19,498Professionalmedian $1,318 · 10th to 90th $933 to $1,950
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 $1,023.29 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,023.29 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,148.15 | Professional | None | $977.24 | $1,023.29 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $10,964.78 Typical High $22,908.68 | Facility | None | $794.33 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $1,778.28 | Professional | None | $933.25 | $1,412.54 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $223.87 Typical High $302.00 | Professional | 80 · Assistant surgeon | $147.91 | $223.87 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $194.98 Typical High $263.03 | Professional | AS · PA/NP assist | $128.82 | $194.98 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $6,456.54 | Facility | None | $1,148.15 | $1,148.15 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,818.38 Typical High $4,677.35 | Facility | None | $549.54 | $2,818.38 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $6,456.54 | Professional | None | $1,023.29 | $1,348.96 | $6,456.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,445.44 Median $5,495.41 Typical High $10,471.29 | Facility | None | $1,445.44 | $5,495.41 | $10,471.29 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,548.82 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,949.84 | Professional | None | $891.25 | $1,202.26 | $1,949.84 |
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 $489.78 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $741.31 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $794.33 |
Where Indiana sits
The same service costs 6.2 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· 31st of 51
$1,413
AK $4,571UT $741
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.