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 $208.93 Median $3,467.37 Typical High $5,623.41 | Facility | None | $208.93 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $257.04 | Professional | None | $208.93 | $234.42 | $257.04 |
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 $199.53 Median $302.00 Typical High $426.58 | Professional | None | $199.53 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $125.89 Median $190.55 Typical High $281.84 | Professional | 62 · Two surgeons | $125.89 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $47.86 Typical High $74.13 | Professional | 80 · Assistant surgeon | $32.36 | $47.86 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $41.69 Typical High $60.26 | Professional | AS · PA/NP assist | $28.18 | $41.69 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $724.44 | Facility | None | $199.53 | $331.13 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $416.87 | Professional | None | $223.87 | $269.15 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $2,089.30 | Facility | None | $257.04 | $549.54 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $436.52 | Professional | None | $213.80 | $295.12 | $436.52 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $416.87 | Professional | None | $204.17 | $281.84 | $416.87 |
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 $104.71 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $104.71 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $41.69 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $154.88 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $25.70 |
Where Indiana sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 31st of 51
$302
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.