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 $7,244.36 | Facility | None | $537.03 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $602.56 | Professional | None | $512.86 | $537.03 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $758.58 Typical High $2,818.38 | Facility | None | $512.86 | $758.58 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $912.01 Typical High $1,122.02 | Professional | None | $467.74 | $912.01 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $575.44 Typical High $724.44 | Professional | 62 · Two surgeons | $295.12 | $575.44 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $147.91 Typical High $199.53 | Professional | 80 · Assistant surgeon | $74.13 | $147.91 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $128.82 Typical High $158.49 | Professional | AS · PA/NP assist | $64.57 | $128.82 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,230.27 | Facility | None | $602.56 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $588.84 Typical High $2,691.53 | Facility | None | $436.52 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $3,890.45 | Professional | None | $575.44 | $741.31 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,187.76 | Facility | None | $912.01 | $1,445.44 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,047.13 | Professional | None | $562.34 | $794.33 | $1,047.13 |
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 $478.63 Median $660.69 Typical High $1,047.13 | Professional | None | $478.63 | $660.69 | $1,047.13 |
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 $257.04 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $60.26 |
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· 27th of 51
$776
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.