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 $5,623.41 | Facility | None | $331.13 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $416.87 | Professional | None | $316.23 | $331.13 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $2,187.76 | Facility | None | $489.78 | $616.60 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $616.60 | Professional | None | $281.84 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $81.28 Typical High $109.65 | Professional | 80 · Assistant surgeon | $45.71 | $81.28 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $70.79 Typical High $89.13 | Professional | AS · PA/NP assist | $39.81 | $70.79 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $912.01 | Facility | None | $371.54 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $575.44 Typical High $2,691.53 | Facility | None | $363.08 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $2,398.83 | Professional | None | $346.74 | $446.68 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $954.99 Typical High $2,187.76 | Facility | None | $870.96 | $954.99 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $645.65 | Professional | None | $346.74 | $489.78 | $645.65 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $645.65 | Professional | None | $295.12 | $398.11 | $645.65 |
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 $158.49 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $239.88 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $37.15 |
Where Indiana sits
The same service costs 4.9 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· 33rd of 51
$447
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.