How much rates vary
Facilitymedian $3,311 · 10th to 90th $331 to $6,918Professionalmedian $380 · 10th to 90th $32 to $589
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 $331.13 Median $2,884.03 Typical High $4,786.30 | Facility | None | $331.13 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $549.54 | Professional | None | $323.59 | $457.09 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,479.11 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $676.08 | Professional | None | $380.19 | $537.03 | $676.08 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $331.13 Typical High $501.19 | Professional | None | $28.18 | $331.13 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,888.44 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $660.69 | Professional | None | $354.81 | $562.34 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $467.74 | Professional | None | $354.81 | $407.38 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $269.15 Median $630.96 Typical High $933.25 | Professional | None | $269.15 | $630.96 | $933.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $724.44 | Professional | None | $309.03 | $457.09 | $724.44 |
7 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 $162.18 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $323.59 | $346.74 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,606.93 Median $8,912.51 Typical High $12,882.50 | Facility | 50 · Both sides | $6,606.93 | $8,912.51 | $12,882.50 |
Where Utah sits
The same service costs 5.3 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 $6,438MT $1,226
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.