How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $1,778 · 10th to 90th $1,349 to $2,692
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 $1,258.93 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,348.96 | $1,737.80 |
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 $1,445.44 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,949.84 | $2,754.23 |
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 $1,318.26 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,659.59 | $2,344.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,348.96 | $1,621.81 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,737.80 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,511.89 Typical High $2,630.27 | Facility | None | $1,258.93 | $2,511.89 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,288.25 | $1,995.26 |
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 $1,318.26 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,659.59 | $2,691.53 |
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 $645.65 Median $660.69 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $812.83 Typical High $1,348.96 | Professional | 62 · Two surgeons | $630.96 | $812.83 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $346.74 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $302.00 |
Where Colorado sits
The same service costs 5.0 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· 18th of 51
$1,820
AK $4,467TX $891
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.