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 $467.74 Median $3,467.37 Typical High $5,011.87 | Facility | None | $467.74 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $524.81 | Professional | None | $426.58 | $467.74 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $812.83 | Professional | None | $354.81 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $97.72 Typical High $147.91 | Professional | 80 · Assistant surgeon | $56.23 | $97.72 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $85.11 Typical High $114.82 | Professional | AS · PA/NP assist | $48.98 | $85.11 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $676.08 Typical High $2,691.53 | Facility | None | $489.78 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $812.83 | Professional | None | $398.11 | $549.54 | $812.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,187.76 | Facility | None | $870.96 | $1,071.52 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $691.83 | Professional | None | $436.52 | $512.86 | $691.83 |
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 $407.38 Median $588.84 Typical High $851.14 | Professional | None | $407.38 | $588.84 | $851.14 |
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 $213.80 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $213.80 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $316.23 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $52.48 |
Where Indiana sits
The same service costs 4.1 times more in Wisconsin 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· 34th of 51
$617
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.