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 $407.38 Median $3,467.37 Typical High $5,011.87 | Facility | None | $407.38 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $512.86 | Professional | None | $407.38 | $407.38 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,370.32 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $812.83 | Professional | None | $371.54 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $389.05 Typical High $524.81 | Professional | 62 · Two surgeons | $234.42 | $389.05 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $100.00 Typical High $141.25 | Professional | 80 · Assistant surgeon | $58.88 | $100.00 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $87.10 Typical High $117.49 | Professional | AS · PA/NP assist | $51.29 | $87.10 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $2,691.53 | Facility | None | $524.81 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $912.01 | Professional | None | $436.52 | $575.44 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,187.76 | Facility | None | $912.01 | $1,122.02 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $812.83 | Professional | None | $457.09 | $616.60 | $812.83 |
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 $389.05 Median $537.03 Typical High $851.14 | Professional | None | $389.05 | $537.03 | $851.14 |
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 $204.17 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $51.29 |
Where Indiana sits
The same service costs 4.3 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· 27th of 51
$617
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.