How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,096 to $12,589Professionalmedian $4,786 · 10th to 90th $3,548 to $7,244
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 $3,311.31 Median $3,548.13 Typical High $4,265.80 | Professional | None | $3,311.31 | $3,548.13 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,981.07 Median $5,248.07 Typical High $7,413.10 | Professional | None | $3,981.07 | $5,248.07 | $7,413.10 |
Denver HMP Setting Facility Modifier None Typical Low $3,548.13 Median $4,365.16 Typical High $8,317.64 | Facility | None | $3,548.13 | $4,365.16 | $8,317.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $4,570.88 Typical High $7,244.36 | Professional | None | $3,630.78 | $4,570.88 | $7,244.36 |
Select Health Setting Facility Modifier None Typical Low $3,311.31 Median $6,606.93 Typical High $6,918.31 | Facility | None | $3,311.31 | $6,606.93 | $6,918.31 |
Select Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $5,248.07 | Professional | None | $2,951.21 | $3,467.37 | $5,248.07 |
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 $3,467.37 Median $4,466.84 Typical High $7,079.46 | Professional | None | $3,467.37 | $4,466.84 | $7,079.46 |
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 $1,698.24 Median $1,778.28 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,698.24 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $851.14 | Professional | 53 · Discontinued | $676.08 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,691.53 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,570.40 | $2,691.53 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $537.03 Typical High $645.65 | Professional | 55 · Aftercare only | $512.86 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $354.81 Typical High $426.58 | Professional | 56 · Pre-op care only | $338.84 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,511.89 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,511.89 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,398.83 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,995.26 | $2,398.83 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $602.56 Typical High $933.25 | Professional | 80 · Assistant surgeon | $501.19 | $602.56 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $537.03 Typical High $812.83 | Professional | AS · PA/NP assist | $436.52 | $537.03 | $812.83 |
Where Colorado sits
The same service costs 27.5 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
$4,898
AK $14,454TX $525
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.