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 $316.23 Median $3,467.37 Typical High $5,011.87 | Facility | None | $316.23 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $380.19 | Professional | None | $288.40 | $316.23 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $12,022.64 Typical High $28,840.32 | Facility | None | $1,621.81 | $12,022.64 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $446.68 Typical High $602.56 | Professional | None | $234.42 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $281.84 Typical High $380.19 | Professional | 62 · Two surgeons | $147.91 | $281.84 | $380.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $72.44 Typical High $107.15 | Professional | 80 · Assistant surgeon | $37.15 | $72.44 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $63.10 Typical High $85.11 | Professional | AS · PA/NP assist | $32.36 | $63.10 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $602.56 Typical High $2,691.53 | Facility | None | $323.59 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $588.84 | Professional | None | $281.84 | $380.19 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $2,187.76 | Facility | None | $588.84 | $741.31 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | None | $288.40 | $346.74 | $467.74 |
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 $275.42 Median $389.05 Typical High $562.34 | Professional | None | $275.42 | $389.05 | $562.34 |
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 $144.54 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $144.54 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $57.54 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $234.42 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $35.48 |
Where Indiana sits
The same service costs 3.9 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· 29th 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.