How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,000 to $15,488Professionalmedian $1,862 · 10th to 90th $1,413 to $2,818
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 $1,348.96 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,412.54 | $1,819.70 |
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 $1,513.56 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,089.30 | $2,884.03 |
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 $1,380.38 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,778.28 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,235.94 | Facility | None | $1,412.54 | $1,778.28 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,819.70 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $2,691.53 | Facility | None | $1,288.25 | $2,570.40 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,348.96 | $2,089.30 |
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 $1,380.38 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,737.80 | $2,818.38 |
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 $676.08 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $870.96 Typical High $1,412.54 | Professional | 62 · Two surgeons | $676.08 | $870.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $223.87 Typical High $363.08 | Professional | 80 · Assistant surgeon | $169.82 | $223.87 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $190.55 Typical High $316.23 | Professional | AS · PA/NP assist | $151.36 | $190.55 | $316.23 |
Where Colorado sits
The same service costs 5.5 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· 21st of 51
$1,905
AK $4,898TX $891
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.