How much rates vary
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 $1,096.48 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,202.26 | $1,380.38 |
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 $1,288.25 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,778.28 | $2,398.83 |
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 $1,174.90 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,479.11 | $2,238.72 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Facility | None | $1,202.26 | $1,202.26 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $6,025.60 | Professional | None | $154.88 | $346.74 | $6,025.60 |
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 $1,148.15 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,380.38 | $2,187.76 |
6 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 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $123.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $575.44 Typical High $933.25 | Professional | 62 · Two surgeons | $436.52 | $575.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $144.54 Typical High $234.42 | Professional | 80 · Assistant surgeon | $109.65 | $144.54 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $125.89 Typical High $199.53 | Professional | AS · PA/NP assist | $97.72 | $125.89 | $199.53 |
Where Colorado sits
The same service costs 5.6 times more in Alaska than in New York. 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· 17th of 51
$1,660
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.