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 $457.09 Median $3,467.37 Typical High $5,011.87 | Facility | None | $457.09 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $588.84 | Professional | None | $398.11 | $457.09 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $28,840.32 | Facility | None | $1,778.28 | $10,715.19 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,584.89 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,513.56 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $389.05 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $338.84 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $66,069.34 Typical High $79,432.82 | Facility | None | $398.11 | $66,069.34 | $79,432.82 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $2,691.53 | Facility | None | $467.74 | $645.65 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $2,089.30 | Professional | None | $380.19 | $501.19 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $2,290.87 | Facility | None | $912.01 | $1,096.48 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $575.44 | Professional | None | $398.11 | $501.19 | $575.44 |
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 $346.74 Median $524.81 Typical High $724.44 | Professional | None | $346.74 | $524.81 | $724.44 |
3 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 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $436.52 | Professional | 54 · Surgery only | $302.00 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $39.81 | $45.71 | $58.88 |
Where Indiana sits
The same service costs 7.1 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· 3rd of 51
$1,585
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.