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 $5,011.87 Typical High $7,244.36 | Facility | None | $331.13 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $398.11 | Professional | None | $302.00 | $331.13 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,125.38 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,125.38 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $562.34 | Professional | None | $281.84 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $67.61 Typical High $93.33 | Professional | 80 · Assistant surgeon | $44.67 | $67.61 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $60.26 Typical High $79.43 | Professional | AS · PA/NP assist | $38.90 | $60.26 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $2,691.53 | Facility | None | $562.34 | $891.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $676.08 | Professional | None | $338.84 | $407.38 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $691.83 Median $912.01 Typical High $2,187.76 | Facility | None | $691.83 | $912.01 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $616.60 | Professional | None | $338.84 | $407.38 | $616.60 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $602.56 | Professional | None | $309.03 | $380.19 | $602.56 |
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 $151.36 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $60.26 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $223.87 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $275.42 |
Where Indiana sits
The same service costs 5.8 times more in Alaska 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· 34th of 51
$427
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.