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 $380.19 Median $380.19 Typical High $501.19 | Professional | None | $380.19 | $380.19 | $501.19 |
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 $416.87 Median $562.34 Typical High $776.25 | Professional | None | $416.87 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $4,786.30 | Facility | None | $645.65 | $2,137.96 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $660.69 | Professional | None | $407.38 | $478.63 | $660.69 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $478.63 Typical High $851.14 | Facility | None | $380.19 | $478.63 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $741.31 | Professional | None | $371.54 | $467.74 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $676.08 Typical High $707.95 | Facility | None | $338.84 | $676.08 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $537.03 | Professional | None | $309.03 | $363.08 | $537.03 |
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 $389.05 Median $489.78 Typical High $776.25 | Professional | None | $389.05 | $489.78 | $776.25 |
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 $281.84 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $281.84 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $45.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $245.47 Typical High $371.54 | Professional | 62 · Two surgeons | $199.53 | $245.47 | $371.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $63.10 Typical High $95.50 | Professional | 80 · Assistant surgeon | $50.12 | $63.10 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $54.95 Typical High $83.18 | Professional | AS · PA/NP assist | $43.65 | $54.95 | $83.18 |
Where Colorado sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 22nd of 51
$537
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.