How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $2,291 · 10th to 90th $1,698 to $3,467
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 $1,659.59 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,659.59 | $1,698.24 | $2,238.72 |
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 $1,862.09 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,862.09 | $2,511.89 | $3,548.13 |
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 $2,137.96 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,137.96 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,890.45 | Facility | None | $1,698.24 | $2,137.96 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,187.76 | $3,467.37 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $3,162.28 Typical High $3,311.31 | Facility | None | $1,584.89 | $3,162.28 | $3,311.31 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,659.59 | $2,511.89 |
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 $1,698.24 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,137.96 | $3,467.37 |
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 $831.76 Median $851.14 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,047.13 Typical High $1,737.80 | Professional | 62 · Two surgeons | $831.76 | $1,047.13 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $436.52 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $229.09 Typical High $380.19 | Professional | AS · PA/NP assist | $181.97 | $229.09 | $380.19 |
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
$2,344
AK $5,888TX $1,096
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.