How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $1,820 · 10th to 90th $1,349 to $2,754
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 $1,318.26 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,348.96 | $1,778.28 |
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 $1,479.11 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,995.26 | $2,818.38 |
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 $1,348.96 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,698.24 | $2,398.83 |
Denver HMP Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,162.28 | Facility | None | $1,348.96 | $1,659.59 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,778.28 | $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 $1,122.02 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,318.26 | $2,041.74 |
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 $1,348.96 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,698.24 | $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 $660.69 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,380.38 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $213.80 Typical High $354.81 | Professional | 80 · Assistant surgeon | $162.18 | $213.80 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $181.97 Typical High $309.03 | Professional | AS · PA/NP assist | $141.25 | $181.97 | $309.03 |
Where Colorado sits
The same service costs 5.4 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· 20th of 51
$1,862
AK $4,677TX $871
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.