How much rates vary
Facilitymedian $15,136 · 10th to 90th $3,162 to $25,704Professionalmedian $1,660 · 10th to 90th $1,259 to $2,512
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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $16,982.44 Typical High $38,904.51 | Facility | None | $11,481.54 | $16,982.44 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,862.09 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $9,772.37 | Facility | None | $758.58 | $5,011.87 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,548.82 | $2,187.76 |
Denver HMP Setting Facility Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,951.21 | Facility | None | $1,258.93 | $1,584.89 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,621.81 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $8,511.38 | Facility | None | $1,174.90 | $2,344.23 | $8,511.38 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,230.27 | $2,187.76 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,584.89 | $2,511.89 |
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 $602.56 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $741.31 Typical High $1,288.25 | Professional | 62 · Two surgeons | $549.54 | $741.31 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $190.55 Typical High $323.59 | Professional | 80 · Assistant surgeon | $141.25 | $190.55 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $165.96 Typical High $288.40 | Professional | AS · PA/NP assist | $123.03 | $165.96 | $288.40 |
Where Colorado sits
The same service costs 25.7 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
$1,778
AK $5,129TX $200
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.