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 $141.25 Median $5,011.87 Typical High $5,623.41 | Facility | None | $141.25 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $173.78 | Professional | None | $128.82 | $141.25 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $346.74 | Professional | None | $204.17 | $251.19 | $346.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $128.82 Median $158.49 Typical High $223.87 | Professional | 62 · Two surgeons | $128.82 | $158.49 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $1,412.54 | Facility | None | $446.68 | $776.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $331.13 | Professional | None | $144.54 | $177.83 | $331.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $549.54 Median $1,047.13 Typical High $2,187.76 | Facility | None | $549.54 | $1,047.13 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $53.70 Median $208.93 Typical High $269.15 | Professional | None | $53.70 | $208.93 | $269.15 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $257.04 | Professional | None | $120.23 | $162.18 | $257.04 |
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 $64.57 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $64.57 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $25.70 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $97.72 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $16.98 |
Where Indiana sits
The same service costs 4.3 times more in Alaska 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· 26th of 51
$251
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.