How much rates vary
Facilitymedian $6,166 · 10th to 90th $977 to $12,589Professionalmedian $2,630 · 10th to 90th $1,995 to $3,981
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 $1,905.46 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,905.46 | $1,995.26 | $2,344.23 |
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 $2,187.76 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,951.21 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,398.83 | $3,467.37 |
Denver HMP Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $4,786.30 | Facility | None | $1,819.70 | $2,344.23 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $4,168.69 | Professional | None | $2,089.30 | $2,630.27 | $4,168.69 |
Select Health Setting Facility Modifier None Typical Low $1,905.46 Median $3,801.89 Typical High $3,981.07 | Facility | None | $1,905.46 | $3,801.89 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,949.84 | $3,019.95 |
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 $1,862.09 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,454.71 | $3,981.07 |
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 $954.99 Median $1,000.00 Typical High $1,148.15 | Professional | 52 · Reduced service | $954.99 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $398.11 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,513.56 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,513.56 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $302.00 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $199.53 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,412.54 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,412.54 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,174.90 Typical High $2,089.30 | Professional | 62 · Two surgeons | $912.01 | $1,174.90 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $302.00 Typical High $524.81 | Professional | 80 · Assistant surgeon | $234.42 | $302.00 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $263.03 Typical High $457.09 | Professional | AS · PA/NP assist | $204.17 | $263.03 | $457.09 |
Where Colorado sits
The same service costs 5.0 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
$2,692
AK $6,607TX $1,318
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.