How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,905 to $10,471Professionalmedian $832 · 10th to 90th $617 to $1,259
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 $602.56 Median $616.60 Typical High $851.14 | Professional | None | $602.56 | $616.60 | $851.14 |
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 $691.83 Median $933.25 Typical High $1,288.25 | Professional | None | $691.83 | $933.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $3,311.31 | Facility | None | $831.76 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,122.02 | Professional | None | $645.65 | $776.25 | $1,122.02 |
Denver HMP Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $1,380.38 | Facility | None | $616.60 | $812.83 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,202.26 | Professional | None | $602.56 | $758.58 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $2,454.71 | Facility | None | $549.54 | $1,096.48 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,000.00 | Professional | None | $512.86 | $602.56 | $1,000.00 |
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 $630.96 Median $794.33 Typical High $1,230.27 | Professional | None | $630.96 | $794.33 | $1,230.27 |
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 $302.00 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $524.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $398.11 Typical High $588.84 | Professional | 62 · Two surgeons | $316.23 | $398.11 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $100.00 Typical High $154.88 | Professional | 80 · Assistant surgeon | $79.43 | $100.00 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $87.10 Typical High $128.82 | Professional | AS · PA/NP assist | $70.79 | $87.10 | $128.82 |
Where Colorado sits
The same service costs 6.5 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
$891
AK $2,455TX $380
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.