How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,188 to $17,783Professionalmedian $851 · 10th to 90th $646 to $1,288
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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $933.25 | Professional | None | $616.60 | $645.65 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,318.26 | Professional | None | $707.95 | $954.99 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,715.35 Typical High $5,754.40 | Facility | None | $831.76 | $3,715.35 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,174.90 | Professional | None | $645.65 | $794.33 | $1,174.90 |
Denver HMP Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $1,513.56 | Facility | None | $645.65 | $812.83 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,318.26 | Professional | None | $660.69 | $831.76 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $5,011.87 | Facility | None | $602.56 | $1,202.26 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,122.02 | Professional | None | $537.03 | $630.96 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $5,370.32 Typical High $13,489.63 | Facility | None | $1,949.84 | $5,370.32 | $13,489.63 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,288.25 | Professional | None | $645.65 | $812.83 | $1,288.25 |
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 $309.03 Median $323.59 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $524.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $389.05 Typical High $616.60 | Professional | 62 · Two surgeons | $295.12 | $389.05 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $97.72 Typical High $169.82 | Professional | 80 · Assistant surgeon | $75.86 | $97.72 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $87.10 Typical High $138.04 | Professional | AS · PA/NP assist | $66.07 | $87.10 | $138.04 |
Where Colorado sits
The same service costs 5.4 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $11,084MT $2,070
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.