How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,000 to $12,589Professionalmedian $2,138 · 10th to 90th $1,622 to $3,236
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 $1,548.82 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,621.81 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,079.46 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,398.83 | $3,311.31 |
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 $1,621.81 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,949.84 | $2,818.38 |
Denver HMP Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,715.35 | Facility | None | $1,621.81 | $2,041.74 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,041.74 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $3,090.30 | Facility | None | $1,479.11 | $2,951.21 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,548.82 | $2,398.83 |
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 $1,584.89 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,995.26 | $3,162.28 |
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 $776.25 Median $794.33 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $380.19 | Professional | 53 · Discontinued | $309.03 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,000.00 Typical High $1,621.81 | Professional | 62 · Two surgeons | $794.33 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $257.04 Typical High $416.87 | Professional | 80 · Assistant surgeon | $199.53 | $257.04 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $223.87 Typical High $363.08 | Professional | AS · PA/NP assist | $173.78 | $223.87 | $363.08 |
Where Colorado sits
The same service costs 20.9 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· 20th of 51
$2,188
AK $5,370TX $257
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.