How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,000 to $12,589Professionalmedian $5,495 · 10th to 90th $4,169 to $8,511
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 $3,890.45 Median $4,168.69 Typical High $5,011.87 | Professional | None | $3,890.45 | $4,168.69 | $5,011.87 |
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 $4,570.88 Median $6,165.95 Typical High $8,709.64 | Professional | None | $4,570.88 | $6,165.95 | $8,709.64 |
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 $4,073.80 Median $5,011.87 Typical High $7,413.10 | Professional | None | $4,073.80 | $5,011.87 | $7,413.10 |
Denver HMP Setting Facility Modifier None Typical Low $3,801.89 Median $5,011.87 Typical High $9,772.37 | Facility | None | $3,801.89 | $5,011.87 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,265.80 Median $5,370.32 Typical High $8,511.38 | Professional | None | $4,265.80 | $5,370.32 | $8,511.38 |
Select Health Setting Facility Modifier None Typical Low $3,890.45 Median $7,762.47 Typical High $8,128.31 | Facility | None | $3,890.45 | $7,762.47 | $8,128.31 |
Select Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $6,165.95 | Professional | None | $3,467.37 | $4,073.80 | $6,165.95 |
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 $3,981.07 Median $5,248.07 Typical High $8,317.64 | Professional | None | $3,981.07 | $5,248.07 | $8,317.64 |
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 $1,995.26 Median $2,089.30 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,995.26 | $2,089.30 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $851.14 Typical High $1,000.00 | Professional | 53 · Discontinued | $794.33 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,162.28 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,019.95 | $3,162.28 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $630.96 Typical High $741.31 | Professional | 55 · Aftercare only | $602.56 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $416.87 Typical High $501.19 | Professional | 56 · Pre-op care only | $398.11 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,951.21 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,951.21 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,454.71 Typical High $4,265.80 | Professional | 62 · Two surgeons | $1,862.09 | $2,454.71 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $616.60 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $478.63 | $616.60 | $1,071.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $537.03 Typical High $954.99 | Professional | AS · PA/NP assist | $416.87 | $537.03 | $954.99 |
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· 20th of 51
$5,623
AK $14,125TX $646
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.