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 $338.84 Median $416.87 Typical High $11,220.18 | Facility | None | $338.84 | $416.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $436.52 | Professional | None | $281.84 | $302.00 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $11,220.18 Typical High $24,547.09 | Facility | None | $1,122.02 | $11,220.18 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $537.03 Typical High $707.95 | Professional | None | $251.19 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $158.49 Median $338.84 Typical High $446.68 | Professional | 62 · Two surgeons | $158.49 | $338.84 | $446.68 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $85.11 Typical High $117.49 | Professional | 80 · Assistant surgeon | $40.74 | $85.11 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $74.13 Typical High $97.72 | Professional | AS · PA/NP assist | $35.48 | $74.13 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $4,570.88 | Facility | None | $316.23 | $316.23 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $5,011.87 | Facility | None | $645.65 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $724.44 | Professional | None | $323.59 | $446.68 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $7,079.46 | Facility | None | $831.76 | $4,786.30 | $7,079.46 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $562.34 | Professional | None | $309.03 | $371.54 | $562.34 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $602.56 | Professional | None | $302.00 | $436.52 | $602.56 |
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 $141.25 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $141.25 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $208.93 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $36.31 |
Where Indiana sits
The same service costs 10.0 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· 24th of 51
$537
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.