How much rates vary
Facilitymedian $6,310 · 10th to 90th $977 to $12,589Professionalmedian $2,042 · 10th to 90th $1,514 to $3,090
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 $1,479.11 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,513.56 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,290.87 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,905.46 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,548.13 | Facility | None | $1,380.38 | $1,905.46 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,949.84 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $2,951.21 | Facility | None | $1,412.54 | $2,818.38 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,479.11 | $2,238.72 |
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 $1,513.56 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,513.56 | $1,905.46 | $3,090.30 |
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 $741.31 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $741.31 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $151.36 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $912.01 Typical High $1,548.82 | Professional | 62 · Two surgeons | $724.44 | $912.01 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $389.05 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $346.74 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $346.74 |
Where Colorado sits
The same service costs 20.9 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· 19th of 51
$2,089
AK $5,129TX $245
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.