How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $8,318Professionalmedian $1,259 · 10th to 90th $912 to $1,738
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $933.25 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,737.80 | Professional | None | $812.83 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,230.27 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $812.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $512.86 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $208.93 Typical High $275.42 | Professional | 80 · Assistant surgeon | $131.83 | $208.93 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $114.82 | $181.97 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $5,754.40 Typical High $9,120.11 | Facility | None | $1,148.15 | $5,754.40 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,230.27 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,318.26 | $1,698.24 |
Martin's Point Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $933.25 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,445.44 | $1,819.70 |
6 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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Maine sits
The same service costs 4.6 times more in Wyoming than in Montana. 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.
Physician feeFacility fee
WY $13,103MT $2,825
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.