How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,413 to $8,913Professionalmedian $1,175 · 10th to 90th $891 to $2,042
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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $5,495.41 | Professional | None | $870.96 | $933.25 | $5,495.41 |
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 $954.99 Median $1,288.25 Typical High $2,238.72 | Professional | None | $954.99 | $1,288.25 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $2,691.53 | Facility | None | $691.83 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,445.44 | Professional | None | $870.96 | $1,071.52 | $1,445.44 |
Denver HMP Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,348.96 | Facility | None | $933.25 | $1,122.02 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,698.24 | Professional | None | $851.14 | $1,148.15 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $1,862.09 | Facility | None | $851.14 | $1,698.24 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,174.90 | Professional | None | $588.84 | $851.14 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $933.25 | $1,122.02 | $1,819.70 |
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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $660.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $524.81 Typical High $758.58 | Professional | 62 · Two surgeons | $371.54 | $524.81 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $134.90 Typical High $194.98 | Professional | 80 · Assistant surgeon | $93.33 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $117.49 Typical High $169.82 | Professional | AS · PA/NP assist | $81.28 | $117.49 | $169.82 |
Where Colorado sits
The same service costs 7.6 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· 10th of 51
$1,549
AK $3,715TX $490
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.