How much rates vary
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 $478.63 Median $489.78 Typical High $1,995.26 | Professional | None | $478.63 | $489.78 | $1,995.26 |
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 $549.54 Median $724.44 Typical High $1,071.52 | Professional | None | $549.54 | $724.44 | $1,071.52 |
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 $501.19 Median $616.60 Typical High $912.01 | Professional | None | $501.19 | $616.60 | $912.01 |
Denver HMP Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,258.93 | Facility | None | $489.78 | $489.78 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $691.83 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,047.13 | Facility | None | $501.19 | $1,000.00 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
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 $478.63 Median $616.60 Typical High $977.24 | Professional | None | $478.63 | $616.60 | $977.24 |
7 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 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $371.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $120.23 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $79.43 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $489.78 Typical High $2,884.03 | Professional | 62 · Two surgeons | $213.80 | $489.78 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $123.03 Typical High $724.44 | Professional | 80 · Assistant surgeon | $53.70 | $123.03 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $107.15 Typical High $630.96 | Professional | AS · PA/NP assist | $46.77 | $107.15 | $630.96 |
Where Colorado sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 18th of 51
$708
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.