How much rates vary
Facilitymedian $8,511 · 10th to 90th $955 to $15,488Professionalmedian $1,349 · 10th to 90th $1,000 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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,318.26 | Professional | None | $977.24 | $1,000.00 | $1,318.26 |
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 $2,089.30 | Professional | None | $1,122.02 | $1,513.56 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,258.93 | $1,778.28 |
Denver HMP Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,398.83 | Facility | None | $1,000.00 | $1,380.38 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,348.96 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $2,041.74 | Facility | None | $954.99 | $1,905.46 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,513.56 | Professional | None | $831.76 | $977.24 | $1,513.56 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,288.25 | $1,995.26 |
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 $489.78 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $645.65 Typical High $1,047.13 | Professional | 62 · Two surgeons | $512.86 | $645.65 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $269.15 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $234.42 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $234.42 |
Where Colorado sits
The same service costs 24.5 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· 19th of 51
$1,413
AK $4,074TX $166
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.