How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,000 to $15,488Professionalmedian $6,457 · 10th to 90th $4,786 to $9,772
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 $3,090.30 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,888.44 | Professional | None | $4,786.30 | $4,786.30 | $5,888.44 |
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 $5,248.07 Median $7,244.36 Typical High $10,232.93 | Professional | None | $5,248.07 | $7,244.36 | $10,232.93 |
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 $4,677.35 Median $6,165.95 Typical High $8,709.64 | Professional | None | $4,677.35 | $6,165.95 | $8,709.64 |
Denver HMP Setting Facility Modifier None Typical Low $4,365.16 Median $6,165.95 Typical High $11,220.18 | Facility | None | $4,365.16 | $6,165.95 | $11,220.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,897.79 Median $6,309.57 Typical High $10,000.00 | Professional | None | $4,897.79 | $6,309.57 | $10,000.00 |
Select Health Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $9,549.93 | Facility | None | $4,466.84 | $8,912.51 | $9,549.93 |
Select Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $7,244.36 | Professional | None | $3,981.07 | $4,677.35 | $7,244.36 |
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 $4,897.79 Median $6,309.57 Typical High $10,000.00 | Professional | None | $4,897.79 | $6,309.57 | $10,000.00 |
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 $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 53 · Discontinued | $954.99 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,630.78 Typical High $4,365.16 | Professional | 54 · Surgery only | $3,630.78 | $3,630.78 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,388.44 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,388.44 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Professional | 62 · Two surgeons | $1,584.89 | $2,818.38 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $724.44 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $407.38 | $724.44 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $630.96 Typical High $1,096.48 | Professional | AS · PA/NP assist | $354.81 | $630.96 | $1,096.48 |
Where Colorado sits
The same service costs 21.9 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· 21st of 51
$6,607
AK $16,596TX $759
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.