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 $239.88 Median $3,467.37 Typical High $5,011.87 | Facility | None | $239.88 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $338.84 | Professional | None | $239.88 | $239.88 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,122.02 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $295.12 | Professional | None | $194.98 | $229.09 | $295.12 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $144.54 Typical High $190.55 | Professional | 62 · Two surgeons | $123.03 | $144.54 | $190.55 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $37.15 Typical High $51.29 | Professional | 80 · Assistant surgeon | $31.62 | $37.15 | $51.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $32.36 Typical High $42.66 | Professional | AS · PA/NP assist | $27.54 | $32.36 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $66,069.34 Typical High $79,432.82 | Facility | None | $251.19 | $66,069.34 | $79,432.82 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $223.87 Median $288.40 Typical High $1,348.96 | Professional | None | $223.87 | $288.40 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $2,290.87 | Facility | None | $758.58 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $467.74 | Professional | None | $309.03 | $398.11 | $467.74 |
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 $199.53 Median $239.88 Typical High $398.11 | Professional | None | $199.53 | $239.88 | $398.11 |
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 $177.83 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $177.83 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $33.88 |
Where Indiana sits
The same service costs 8.1 times more in New York than in Missouri. 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· 48th of 51
$240
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.