How much rates vary
Facilitymedian $6,457 · 10th to 90th $933 to $12,589Professionalmedian $5,623 · 10th to 90th $4,266 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 $4,073.80 Median $4,265.80 Typical High $5,128.61 | Professional | None | $4,073.80 | $4,265.80 | $5,128.61 |
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 $4,677.35 Median $6,309.57 Typical High $8,912.51 | Professional | None | $4,677.35 | $6,309.57 | $8,912.51 |
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 $4,265.80 Median $5,370.32 Typical High $7,413.10 | Professional | None | $4,265.80 | $5,370.32 | $7,413.10 |
Denver HMP Setting Facility Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $9,772.37 | Facility | None | $4,265.80 | $5,248.07 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,365.16 Median $5,495.41 Typical High $8,709.64 | Professional | None | $4,365.16 | $5,495.41 | $8,709.64 |
Select Health Setting Facility Modifier None Typical Low $3,981.07 Median $7,943.28 Typical High $8,317.64 | Facility | None | $3,981.07 | $7,943.28 | $8,317.64 |
Select Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $6,309.57 | Professional | None | $3,548.13 | $4,168.69 | $6,309.57 |
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 $4,073.80 Median $5,370.32 Typical High $8,511.38 | Professional | None | $4,073.80 | $5,370.32 | $8,511.38 |
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 $2,089.30 Median $2,137.96 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,089.30 | $2,137.96 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $851.14 Typical High $1,023.29 | Professional | 53 · Discontinued | $831.76 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,235.94 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,090.30 | $3,235.94 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $645.65 Typical High $758.58 | Professional | 55 · Aftercare only | $630.96 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $426.58 Typical High $512.86 | Professional | 56 · Pre-op care only | $416.87 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,019.95 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,019.95 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,691.53 Typical High $4,365.16 | Professional | 62 · Two surgeons | $2,089.30 | $2,691.53 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $691.83 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $524.81 | $691.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $602.56 Typical High $954.99 | Professional | AS · PA/NP assist | $467.74 | $602.56 | $954.99 |
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· 20th of 51
$5,623
AK $14,125TX $676
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.