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 $114.82 Median $5,011.87 Typical High $5,623.41 | Facility | None | $114.82 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | None | $114.82 | $114.82 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,918.31 Typical High $10,000.00 | Facility | None | $3,801.89 | $6,918.31 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $194.98 | Professional | None | $97.72 | $141.25 | $194.98 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $22.39 Typical High $34.67 | Professional | 80 · Assistant surgeon | $15.49 | $22.39 | $34.67 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $13.49 Median $19.50 Typical High $26.92 | Professional | AS · PA/NP assist | $13.49 | $19.50 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $234.42 | Facility | None | $128.82 | $199.53 | $234.42 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $912.01 Typical High $2,187.76 | Facility | None | $295.12 | $912.01 | $2,187.76 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $6,456.54 | Facility | None | $2,754.23 | $4,168.69 | $6,456.54 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $245.47 | Professional | None | $107.15 | $162.18 | $245.47 |
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 $57.54 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $22.91 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $93.33 | Professional | 54 · Surgery only | $85.11 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $18.62 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $12.59 |
Where Indiana sits
The same service costs 37.2 times more in Oklahoma 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· 37th of 51
$174
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.