How much rates vary
Facilitymedian $10,000 · 10th to 90th $933 to $17,783Professionalmedian $1,047 · 10th to 90th $776 to $1,585
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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,047.13 | Professional | None | $758.58 | $776.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,413.10 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,621.81 | Professional | None | $870.96 | $1,174.90 | $1,621.81 |
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 $812.83 Median $977.24 Typical High $1,412.54 | Professional | None | $812.83 | $977.24 | $1,412.54 |
Denver HMP Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,819.70 | Facility | None | $776.25 | $1,000.00 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,621.81 | Professional | None | $812.83 | $1,023.29 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $1,445.44 Typical High $1,548.82 | Facility | None | $724.44 | $1,445.44 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,174.90 | Professional | None | $645.65 | $758.58 | $1,174.90 |
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 $776.25 Median $977.24 Typical High $1,548.82 | Professional | None | $776.25 | $977.24 | $1,548.82 |
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 $380.19 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $478.63 Typical High $912.01 | Professional | 62 · Two surgeons | $363.08 | $478.63 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $120.23 Typical High $229.09 | Professional | 80 · Assistant surgeon | $91.20 | $120.23 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $104.71 Typical High $181.97 | Professional | AS · PA/NP assist | $81.28 | $104.71 | $181.97 |
Where Colorado sits
The same service costs 5.9 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
$1,096
AK $3,162TX $537
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.