How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,023 to $8,511Professionalmedian $1,549 · 10th to 90th $1,175 to $2,344
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 $1,122.02 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,248.07 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,737.80 | $2,398.83 |
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 $1,148.15 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,445.44 | $2,041.74 |
Denver HMP Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,754.23 | Facility | None | $1,047.13 | $1,445.44 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,513.56 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $2,290.87 | Facility | None | $1,096.48 | $2,187.76 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,737.80 | Professional | None | $977.24 | $1,148.15 | $1,737.80 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $4,786.30 | Facility | None | $660.69 | $1,380.38 | $4,786.30 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
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 $562.34 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $676.08 Typical High $1,202.26 | Professional | 62 · Two surgeons | $512.86 | $676.08 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $173.78 Typical High $302.00 | Professional | 80 · Assistant surgeon | $128.82 | $173.78 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $147.91 Typical High $269.15 | Professional | AS · PA/NP assist | $112.20 | $147.91 | $269.15 |
Where Colorado sits
The same service costs 5.5 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
$1,585
AK $4,266TX $776
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.