How much rates vary
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 $588.84 Median $5,011.87 Typical High $7,244.36 | Facility | None | $588.84 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | None | $537.03 | $588.84 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $912.01 | Professional | None | $501.19 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $109.65 Typical High $154.88 | Professional | 80 · Assistant surgeon | $83.18 | $109.65 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $95.50 Typical High $128.82 | Professional | AS · PA/NP assist | $69.18 | $95.50 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,737.80 | Facility | None | $645.65 | $645.65 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,288.25 Typical High $2,187.76 | Facility | None | $549.54 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $4,786.30 | Professional | None | $478.63 | $676.08 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $2,344.23 | Facility | None | $912.01 | $1,819.70 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,258.93 | Professional | None | $588.84 | $891.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,096.48 | Professional | None | $457.09 | $616.60 | $1,096.48 |
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 $269.15 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $457.09 |
Where Indiana sits
The same service costs 7.4 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
$676
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.