How much rates vary
Facilitymedian $6,166 · 10th to 90th $977 to $12,589Professionalmedian $3,020 · 10th to 90th $2,291 to $4,571
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 $2,187.76 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,290.87 | $2,691.53 |
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 $2,511.89 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,511.89 | $3,388.44 | $4,786.30 |
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 $2,137.96 Median $2,754.23 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,754.23 | $3,981.07 |
Denver HMP Setting Facility Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $5,370.32 | Facility | None | $2,290.87 | $2,691.53 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $4,786.30 | Professional | None | $2,398.83 | $3,019.95 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $2,187.76 Median $4,365.16 Typical High $4,570.88 | Facility | None | $2,187.76 | $4,365.16 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,905.46 | $2,238.72 | $3,467.37 |
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 $2,137.96 Median $2,818.38 Typical High $4,570.88 | Professional | None | $2,137.96 | $2,818.38 | $4,570.88 |
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 $1,096.48 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,096.48 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $457.09 Typical High $537.03 | Professional | 53 · Discontinued | $436.52 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,737.80 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,621.81 | $1,737.80 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $346.74 Typical High $407.38 | Professional | 55 · Aftercare only | $323.59 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,621.81 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,621.81 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,380.38 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,071.52 | $1,380.38 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $346.74 Typical High $602.56 | Professional | 80 · Assistant surgeon | $269.15 | $346.74 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $302.00 Typical High $524.81 | Professional | AS · PA/NP assist | $239.88 | $302.00 | $524.81 |
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· 19th of 51
$3,090
AK $7,586TX $363
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.