How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,995 to $10,471Professionalmedian $1,288 · 10th to 90th $977 to $1,995
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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,348.96 | Professional | None | $933.25 | $977.24 | $1,348.96 |
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 $1,071.52 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,445.44 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,137.96 Typical High $3,801.89 | Facility | None | $933.25 | $2,137.96 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,737.80 | Professional | None | $977.24 | $1,174.90 | $1,737.80 |
Denver HMP Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,187.76 | Facility | None | $977.24 | $1,258.93 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,949.84 | Professional | None | $954.99 | $1,230.27 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $2,454.71 | Facility | None | $870.96 | $1,737.80 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,621.81 | Professional | None | $812.83 | $954.99 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,949.84 | Professional | None | $954.99 | $1,230.27 | $1,949.84 |
8 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 $467.74 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $151.36 Typical High $245.47 | Professional | 80 · Assistant surgeon | $123.03 | $151.36 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $208.93 |
Where Colorado sits
The same service costs 6.2 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· 17th of 51
$1,380
AK $3,802TX $617
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.