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 $3,890.45 Typical High $5,011.87 | Facility | None | $2,344.23 | $3,890.45 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $4,365.16 | Professional | None | $3,467.37 | $3,890.45 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $4,265.80 Typical High $5,754.40 | Professional | None | $2,884.03 | $4,265.80 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $676.08 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $467.74 | $676.08 | $1,023.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $588.84 Typical High $812.83 | Professional | AS · PA/NP assist | $407.38 | $588.84 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $5,495.41 | Facility | None | $575.44 | $2,691.53 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,235.94 | $4,570.88 | $5,623.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,365.16 Typical High $8,912.51 | Facility | None | $912.01 | $4,365.16 | $8,912.51 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $5,623.41 | Professional | None | $3,548.13 | $4,265.80 | $5,623.41 |
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 $4,786.30 Typical High $6,918.31 | Professional | None | $3,235.94 | $4,786.30 | $6,918.31 |
4 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 $1,737.80 Median $1,949.84 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,737.80 | $1,949.84 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $776.25 Typical High $870.96 | Professional | 53 · Discontinued | $707.95 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,884.03 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,630.27 | $2,884.03 | $3,235.94 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,691.53 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,691.53 | $3,019.95 |
Where Indiana sits
The same service costs 7.6 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· 29th of 51
$4,266
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.