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 $331.13 Median $3,467.37 Typical High $5,011.87 | Facility | None | $331.13 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $407.38 | Professional | None | $316.23 | $331.13 | $407.38 |
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 $1,995.26 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,344.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $588.84 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $331.13 Typical High $467.74 | Professional | AS · PA/NP assist | $281.84 | $331.13 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $66,069.34 Typical High $79,432.82 | Facility | None | $331.13 | $66,069.34 | $79,432.82 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $2,691.53 | Facility | None | $398.11 | $645.65 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $3,090.30 | Professional | None | $331.13 | $436.52 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $2,290.87 | Facility | None | $912.01 | $1,047.13 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $549.54 | Professional | None | $389.05 | $446.68 | $549.54 |
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 $316.23 Median $398.11 Typical High $602.56 | Professional | None | $316.23 | $398.11 | $602.56 |
3 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 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $239.88 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $61.66 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $40.74 |
Where Indiana sits
The same service costs 9.8 times more in Indiana than in Hawaii. 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· 1st of 51
$2,344
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.