How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,096 to $8,511Professionalmedian $3,388 · 10th to 90th $2,692 to $6,026
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 $2,570.40 Median $2,754.23 Typical High $6,025.60 | Professional | None | $2,570.40 | $2,754.23 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,801.89 Typical High $6,456.54 | Professional | None | $2,818.38 | $3,801.89 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,698.24 Typical High $3,311.31 | Facility | None | $831.76 | $1,698.24 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,162.28 | $4,168.69 |
Denver HMP Setting Facility Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $3,890.45 | Facility | None | $2,454.71 | $3,235.94 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $4,786.30 | Professional | None | $2,398.83 | $3,235.94 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $5,011.87 | Facility | None | $1,737.80 | $2,398.83 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,398.83 | $3,311.31 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $5,370.32 | Professional | None | $2,754.23 | $3,311.31 | $5,370.32 |
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 $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,258.93 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,905.46 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,584.89 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,174.90 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $398.11 Typical High $575.44 | Professional | 80 · Assistant surgeon | $295.12 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $354.81 Typical High $501.19 | Professional | AS · PA/NP assist | $257.04 | $354.81 | $501.19 |
Where Colorado sits
The same service costs 15.8 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· 14th of 51
$3,631
AK $8,128TX $513
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.