How much rates vary
Facilitymedian $6,310 · 10th to 90th $977 to $12,589Professionalmedian $1,349 · 10th to 90th $1,023 to $2,042
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 $977.24 Median $1,023.29 Typical High $1,288.25 | Professional | None | $977.24 | $1,023.29 | $1,288.25 |
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 $1,122.02 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,513.56 | $2,137.96 |
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 $954.99 Median $1,258.93 Typical High $1,778.28 | Professional | None | $954.99 | $1,258.93 | $1,778.28 |
Denver HMP Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,454.71 | Facility | None | $1,023.29 | $1,230.27 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,380.38 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,995.26 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,548.82 | Professional | None | $831.76 | $1,000.00 | $1,548.82 |
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 $977.24 Median $1,258.93 Typical High $1,995.26 | Professional | None | $977.24 | $1,258.93 | $1,995.26 |
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 $489.78 Median $512.86 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $630.96 Typical High $1,071.52 | Professional | 62 · Two surgeons | $478.63 | $630.96 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $162.18 Typical High $269.15 | Professional | 80 · Assistant surgeon | $123.03 | $162.18 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $141.25 Typical High $239.88 | Professional | AS · PA/NP assist | $107.15 | $141.25 | $239.88 |
Where Colorado sits
The same service costs 4.9 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
$1,413
AK $3,548TX $724
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.