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 $537.03 Median $5,011.87 Typical High $16,595.87 | Facility | None | $537.03 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | None | $489.78 | $537.03 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,549.93 | Facility | None | $1,380.38 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $912.01 | Professional | None | $446.68 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $107.15 Typical High $154.88 | Professional | 80 · Assistant surgeon | $72.44 | $107.15 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $95.50 Typical High $128.82 | Professional | AS · PA/NP assist | $63.10 | $95.50 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $4,570.88 | Facility | None | $562.34 | $562.34 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,311.31 Typical High $5,011.87 | Facility | None | $812.83 | $3,311.31 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,071.52 | Professional | None | $562.34 | $676.08 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $4,168.69 Typical High $7,079.46 | Facility | None | $1,348.96 | $4,168.69 | $7,079.46 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,000.00 | Professional | None | $549.54 | $676.08 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $977.24 | Professional | None | $501.19 | $630.96 | $977.24 |
6 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 $245.47 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $371.54 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $446.68 |
Where Indiana sits
The same service costs 8.3 times more in Oklahoma than in Utah. 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· 41st of 51
$676
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.