How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,820 to $15,488Professionalmedian $708 · 10th to 90th $87 to $1,230
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 $1,819.70 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,819.70 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,548.82 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $676.08 Typical High $977.24 | Professional | None | $85.11 | $676.08 | $977.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,737.80 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,380.38 | $2,089.30 | $2,454.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,122.02 | $2,089.30 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,288.25 | $2,187.76 |
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 52 · Reduced service Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $724.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,258.93 | $1,258.93 |
Where Utah sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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 $14,661HI $3,664
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.