How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,000 to $15,488Professionalmedian $2,089 · 10th to 90th $1,549 to $3,162
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 $1,548.82 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,548.82 | $2,089.30 |
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 $1,737.80 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,344.23 | $3,235.94 |
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 $1,737.80 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,737.80 | $2,041.74 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $3,630.78 | Facility | None | $1,548.82 | $2,238.72 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,041.74 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $3,090.30 | Facility | None | $1,445.44 | $2,884.03 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,513.56 | $2,344.23 |
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 $1,659.59 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,089.30 | $3,162.28 |
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 $776.25 Median $776.25 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 53 · Discontinued | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,047.13 Typical High $1,819.70 | Professional | 62 · Two surgeons | $812.83 | $1,047.13 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $234.42 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $234.42 | $354.81 |
Where Colorado sits
The same service costs 5.4 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· 20th of 51
$2,188
AK $5,623TX $1,047
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.