How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,000 to $12,589Professionalmedian $5,129 · 10th to 90th $3,890 to $7,762
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 $3,090.30 Median $5,495.41 Typical High $8,912.51 | Facility | None | $3,090.30 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,890.45 Typical High $4,677.35 | Professional | None | $3,548.13 | $3,890.45 | $4,677.35 |
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 $4,168.69 Median $5,754.40 Typical High $8,128.31 | Professional | None | $4,168.69 | $5,754.40 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $5,011.87 | Facility | None | $676.08 | $2,344.23 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $4,677.35 Typical High $6,760.83 | Professional | None | $3,890.45 | $4,677.35 | $6,760.83 |
Denver HMP Setting Facility Modifier None Typical Low $3,467.37 Median $4,897.79 Typical High $8,912.51 | Facility | None | $3,467.37 | $4,897.79 | $8,912.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $7,943.28 | Professional | None | $3,981.07 | $5,011.87 | $7,943.28 |
Select Health Setting Facility Modifier None Typical Low $3,548.13 Median $7,244.36 Typical High $7,585.78 | Facility | None | $3,548.13 | $7,244.36 | $7,585.78 |
Select Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $5,754.40 | Professional | None | $3,235.94 | $3,801.89 | $5,754.40 |
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 $3,715.35 Median $4,786.30 Typical High $7,762.47 | Professional | None | $3,715.35 | $4,786.30 | $7,762.47 |
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 $1,862.09 Median $1,949.84 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,862.09 | $1,949.84 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $776.25 Typical High $912.01 | Professional | 53 · Discontinued | $741.31 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,884.03 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,754.23 | $2,884.03 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $588.84 Typical High $691.83 | Professional | 55 · Aftercare only | $549.54 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $389.05 Typical High $457.09 | Professional | 56 · Pre-op care only | $371.54 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,691.53 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,691.53 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $2,290.87 Typical High $3,981.07 | Professional | 62 · Two surgeons | $1,778.28 | $2,290.87 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $575.44 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $457.09 | $575.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $501.19 Typical High $870.96 | Professional | AS · PA/NP assist | $398.11 | $501.19 | $870.96 |
Where Colorado sits
The same service costs 21.9 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
$5,129
AK $13,183TX $603
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.