How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,512 to $15,488Professionalmedian $1,349 · 10th to 90th $1,000 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 $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 $954.99 Median $1,023.29 Typical High $1,348.96 | Professional | None | $954.99 | $1,023.29 | $1,348.96 |
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 $1,122.02 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,513.56 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $5,754.40 | Facility | None | $954.99 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,737.80 | Professional | None | $977.24 | $1,202.26 | $1,737.80 |
Denver HMP Setting Facility Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,511.89 | Facility | None | $977.24 | $1,288.25 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,380.38 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $5,011.87 | Facility | None | $1,000.00 | $1,995.26 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,862.09 | Professional | None | $831.76 | $1,000.00 | $1,862.09 |
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 $1,202.26 Typical High $1,949.84 | Professional | None | $954.99 | $1,202.26 | $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 $478.63 Median $512.86 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $154.88 Typical High $269.15 | Professional | 80 · Assistant surgeon | $123.03 | $154.88 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $134.90 Typical High $234.42 | Professional | AS · PA/NP assist | $107.15 | $134.90 | $234.42 |
Where Colorado sits
The same service costs 5.8 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· 16th of 51
$1,413
AK $3,981TX $692
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.