How much rates vary
Facilitymedian $6,166 · 10th to 90th $2,089 to $12,589Professionalmedian $2,239 · 10th to 90th $1,778 to $3,981
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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $6,025.60 | Professional | None | $1,698.24 | $1,819.70 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,511.89 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,691.53 Typical High $3,715.35 | Facility | None | $831.76 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,041.74 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,570.40 | Facility | None | $1,819.70 | $2,187.76 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,187.76 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $3,311.31 | Facility | None | $1,584.89 | $3,019.95 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,584.89 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,819.70 | $2,187.76 | $3,548.13 |
9 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 $831.76 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,047.13 Typical High $1,479.11 | Professional | 62 · Two surgeons | $724.44 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $263.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $181.97 | $263.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $229.09 Typical High $331.13 | Professional | AS · PA/NP assist | $162.18 | $229.09 | $331.13 |
Where Colorado sits
The same service costs 8.7 times more in Alaska than in Texas. 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.
Colorado· 11th of 51
$2,884
AK $7,244TX $832
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.