How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $1,698 · 10th to 90th $1,259 to $2,570
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 $1,230.27 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,258.93 | $1,659.59 |
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 $1,412.54 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,905.46 | $2,630.27 |
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 $1,258.93 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,584.89 | $2,290.87 |
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 $1,318.26 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,659.59 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,398.83 Typical High $2,511.89 | Facility | None | $1,174.90 | $2,398.83 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,230.27 | $1,905.46 |
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 $1,258.93 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,584.89 | $2,570.40 |
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 $616.60 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $257.04 | $302.00 |
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 $186.21 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $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 $602.56 Median $794.33 Typical High $1,288.25 | Professional | 62 · Two surgeons | $602.56 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $199.53 Typical High $331.13 | Professional | 80 · Assistant surgeon | $154.88 | $199.53 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $177.83 Typical High $288.40 | Professional | AS · PA/NP assist | $134.90 | $177.83 | $288.40 |
Where Colorado sits
The same service costs 22.4 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· 21st of 51
$1,738
AK $4,467TX $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.