How much rates vary
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 $245.47 Median $269.15 Typical High $501.19 | Professional | None | $245.47 | $269.15 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $562.34 | Professional | None | $288.40 | $398.11 | $562.34 |
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 $263.03 Median $316.23 Typical High $457.09 | Professional | None | $263.03 | $316.23 | $457.09 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $295.12 Typical High $660.69 | Facility | None | $269.15 | $295.12 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $588.84 | Professional | None | $295.12 | $371.54 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $537.03 Typical High $562.34 | Facility | None | $269.15 | $537.03 | $562.34 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $416.87 | Professional | None | $269.15 | $269.15 | $416.87 |
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 $229.09 Median $281.84 Typical High $457.09 | Professional | None | $229.09 | $281.84 | $457.09 |
6 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 54 · Surgery only Typical Low $181.97 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $181.97 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $33.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $109.65 Median $213.80 Typical High $1,380.38 | Professional | 62 · Two surgeons | $109.65 | $213.80 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $54.95 Typical High $354.81 | Professional | 80 · Assistant surgeon | $28.18 | $54.95 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $47.86 Typical High $309.03 | Professional | AS · PA/NP assist | $24.55 | $47.86 | $309.03 |
Where Colorado sits
The same service costs 8.1 times more in New York than in Missouri. 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
$372
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.