How much rates vary
Facilitymedian $2,692 · 10th to 90th $759 to $5,370Professionalmedian $813 · 10th to 90th $617 to $1,259
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 $562.34 Median $616.60 Typical High $776.25 | Professional | None | $562.34 | $616.60 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,288.25 | Professional | None | $676.08 | $912.01 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $870.96 Typical High $2,691.53 | Facility | None | $616.60 | $870.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,071.52 | Professional | None | $588.84 | $741.31 | $1,071.52 |
Denver HMP Setting Facility Modifier None Typical Low $616.60 Median $724.44 Typical High $1,513.56 | Facility | None | $616.60 | $724.44 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,318.26 | Professional | None | $660.69 | $831.76 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $831.76 Typical High $1,258.93 | Facility | None | $602.56 | $831.76 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $954.99 | Professional | None | $512.86 | $602.56 | $954.99 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $4,786.30 | Facility | None | $676.08 | $1,412.54 | $4,786.30 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,202.26 | Professional | None | $588.84 | $758.58 | $1,202.26 |
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 $281.84 Median $309.03 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $501.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $354.81 Typical High $645.65 | Professional | 62 · Two surgeons | $275.42 | $354.81 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $89.13 Typical High $165.96 | Professional | 80 · Assistant surgeon | $70.79 | $89.13 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $77.62 Typical High $144.54 | Professional | AS · PA/NP assist | $61.66 | $77.62 | $144.54 |
Where Colorado sits
The same service costs 5.0 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· 18th of 51
$851
AK $2,138TX $427
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.