How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,072 to $12,589Professionalmedian $1,950 · 10th to 90th $1,479 to $2,951
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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,187.76 | $3,090.30 |
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 $1,513.56 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,819.70 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $3,388.44 | Facility | None | $1,479.11 | $1,862.09 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,905.46 | $3,019.95 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $2,884.03 | Facility | None | $1,380.38 | $2,754.23 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,445.44 | $2,187.76 |
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 $1,479.11 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,862.09 | $2,951.21 |
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 $707.95 Median $741.31 Typical High $870.96 | Professional | 52 · Reduced service | $707.95 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $346.74 | Professional | 53 · Discontinued | $281.84 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $173.78 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $891.25 Typical High $1,513.56 | Professional | 62 · Two surgeons | $707.95 | $891.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $229.09 Typical High $380.19 | Professional | 80 · Assistant surgeon | $181.97 | $229.09 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $158.49 | $199.53 | $331.13 |
Where Colorado sits
The same service costs 5.2 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· 19th of 51
$2,042
AK $5,129TX $977
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.