How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,512 to $15,488Professionalmedian $955 · 10th to 90th $724 to $1,445
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 $4,365.16 Typical High $11,748.98 | Facility | None | $2,570.40 | $4,365.16 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,023.29 | Professional | None | $691.83 | $724.44 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,479.11 | Professional | None | $794.33 | $1,071.52 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | None | $724.44 | $870.96 | $1,258.93 |
Denver HMP Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $1,659.59 | Facility | None | $724.44 | $933.25 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,445.44 | Professional | None | $724.44 | $912.01 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $5,011.87 | Facility | None | $660.69 | $1,318.26 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,230.27 | Professional | None | $588.84 | $707.95 | $1,230.27 |
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 $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
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 $346.74 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $114.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $93.33 | $114.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $158.49 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $158.49 |
Where Colorado sits
The same service costs 6.3 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· 18th of 51
$1,023
AK $2,884TX $457
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.