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 $794.33 Median $5,011.87 Typical High $14,125.38 | Facility | None | $794.33 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,096.48 | Professional | None | $741.31 | $794.33 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $14,791.08 Typical High $33,113.11 | Facility | None | $2,137.96 | $14,791.08 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,754.23 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $446.68 Typical High $660.69 | Professional | 80 · Assistant surgeon | $331.13 | $446.68 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $389.05 Typical High $524.81 | Professional | AS · PA/NP assist | $295.12 | $389.05 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $17,782.79 Typical High $26,915.35 | Facility | None | $1,202.26 | $17,782.79 | $26,915.35 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,165.95 Typical High $10,232.93 | Facility | None | $645.65 | $6,165.95 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $5,754.40 Typical High $5,754.40 | Professional | None | $3,630.78 | $5,754.40 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $9,549.93 | Facility | None | $912.01 | $954.99 | $9,549.93 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,348.96 | $2,187.76 |
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 $371.54 Median $398.11 Typical High $549.54 | Professional | 52 · Reduced service | $371.54 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $218.78 | Professional | 53 · Discontinued | $147.91 | $158.49 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $831.76 | Professional | 54 · Surgery only | $562.34 | $588.84 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $165.96 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $109.65 |
Where Indiana sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 6th of 51
$2,754
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.