How much rates vary
Facilitymedian $6,310 · 10th to 90th $977 to $12,589Professionalmedian $1,514 · 10th to 90th $1,148 to $2,291
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 $1,122.02 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,148.15 | $1,479.11 |
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 $1,258.93 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,698.24 | $2,344.23 |
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 $1,174.90 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,412.54 | $2,041.74 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,630.27 | Facility | None | $1,071.52 | $1,445.44 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,479.11 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $2,187.76 | Facility | None | $1,047.13 | $2,089.30 | $2,187.76 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
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 $1,122.02 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,412.54 | $2,290.87 |
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 $562.34 Median $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $724.44 Typical High $1,148.15 | Professional | 62 · Two surgeons | $575.44 | $724.44 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $295.12 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $162.18 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $162.18 | $257.04 |
Where Colorado sits
The same service costs 5.6 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· 19th of 51
$1,585
AK $4,266TX $759
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.