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 $446.68 Median $5,011.87 Typical High $11,220.18 | Facility | None | $446.68 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | None | $446.68 | $446.68 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $28,840.32 | Facility | None | $1,778.28 | $10,715.19 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $933.25 | Professional | None | $398.11 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $64.57 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $100.00 Typical High $131.83 | Professional | AS · PA/NP assist | $56.23 | $100.00 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $6,606.93 Typical High $10,964.78 | Facility | None | $630.96 | $6,606.93 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $977.24 | Professional | None | $467.74 | $660.69 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,388.44 Typical High $15,135.61 | Facility | None | $954.99 | $3,388.44 | $15,135.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $891.25 | Professional | None | $489.78 | $588.84 | $891.25 |
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 $446.68 Median $575.44 Typical High $831.76 | Professional | None | $446.68 | $575.44 | $831.76 |
5 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 $223.87 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 53 · Discontinued | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $56.23 |
Where Indiana sits
The same service costs 3.9 times more in Alaska than in New York. 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· 32nd of 51
$708
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.