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 $2,344.23 Median $3,801.89 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,801.89 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $4,168.69 | Professional | None | $3,388.44 | $3,801.89 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,445.44 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,162.28 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 80 · Assistant surgeon | $426.58 | $501.19 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $446.68 Typical High $676.08 | Professional | AS · PA/NP assist | $380.19 | $446.68 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $5,248.07 | Professional | None | $3,162.28 | $4,168.69 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,365.16 Typical High $8,709.64 | Facility | None | $912.01 | $4,365.16 | $8,709.64 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $6,456.54 | Professional | None | $3,235.94 | $4,073.80 | $6,456.54 |
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 $3,235.94 Median $4,677.35 Typical High $6,760.83 | Professional | None | $3,235.94 | $4,677.35 | $6,760.83 |
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 $1,698.24 Median $1,905.46 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,698.24 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 53 · Discontinued | $676.08 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,818.38 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,570.40 | $2,818.38 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $562.34 Typical High $630.96 | Professional | 55 · Aftercare only | $512.86 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | 56 · Pre-op care only | $338.84 | $380.19 | $416.87 |
Where Indiana sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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
$3,802
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.