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 $812.83 Median $3,467.37 Typical High $5,011.87 | Facility | None | $812.83 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,000.00 | Professional | None | $741.31 | $812.83 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,412.54 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,288.25 | Professional | None | $616.60 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $154.88 Typical High $229.09 | Professional | 80 · Assistant surgeon | $97.72 | $154.88 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $85.11 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
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 $724.44 Median $1,023.29 Typical High $1,479.11 | Professional | None | $724.44 | $1,023.29 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $2,187.76 | Facility | None | $912.01 | $1,862.09 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,380.38 | Professional | None | $691.83 | $870.96 | $1,380.38 |
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 $707.95 Median $1,023.29 Typical High $1,479.11 | Professional | None | $707.95 | $1,023.29 | $1,479.11 |
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 $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $91.20 |
Where Indiana sits
The same service costs 3.8 times more in Wisconsin than in New York. 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· 35th of 51
$1,000
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.