How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,023 to $12,589Professionalmedian $6,457 · 10th to 90th $4,898 to $9,772
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 $1,995.26 Median $4,897.79 Typical High $10,964.78 | Facility | None | $1,995.26 | $4,897.79 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $6,456.54 | Professional | None | $4,570.88 | $4,897.79 | $6,456.54 |
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 $5,370.32 Median $7,244.36 Typical High $10,000.00 | Professional | None | $5,370.32 | $7,244.36 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $8,511.38 | Professional | None | $4,897.79 | $6,165.95 | $8,511.38 |
Denver HMP Setting Facility Modifier None Typical Low $4,365.16 Median $6,165.95 Typical High $10,964.78 | Facility | None | $4,365.16 | $6,165.95 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $9,772.37 | Professional | None | $4,897.79 | $6,165.95 | $9,772.37 |
Select Health Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $9,332.54 | Facility | None | $4,466.84 | $8,912.51 | $9,332.54 |
Select Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $7,079.46 | Professional | None | $3,981.07 | $4,677.35 | $7,079.46 |
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 $4,897.79 Median $6,165.95 Typical High $10,000.00 | Professional | None | $4,897.79 | $6,165.95 | $10,000.00 |
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 $2,398.83 Median $2,454.71 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,398.83 | $2,454.71 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 53 · Discontinued | $977.24 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,630.78 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,630.78 | $3,630.78 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $489.78 Typical High $588.84 | Professional | 56 · Pre-op care only | $478.63 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,388.44 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,388.44 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $2,818.38 Typical High $4,897.79 | Professional | 62 · Two surgeons | $2,041.74 | $2,818.38 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $724.44 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $524.81 | $724.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $630.96 Typical High $1,096.48 | Professional | AS · PA/NP assist | $457.09 | $630.96 | $1,096.48 |
Where Colorado sits
The same service costs 20.0 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· 22nd of 51
$6,457
AK $15,488TX $776
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.