How much rates vary
Facilitymedian $5,754 · 10th to 90th $977 to $15,488Professionalmedian $372 · 10th to 90th $59 to $676
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 $977.24 Median $4,570.88 Typical High $8,912.51 | Facility | None | $977.24 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $977.24 | Professional | None | $707.95 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,623.41 Typical High $5,754.40 | Facility | None | $5,370.32 | $5,623.41 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $977.24 | Professional | None | $831.76 | $851.14 | $977.24 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $346.74 Typical High $537.03 | Professional | None | $56.23 | $346.74 | $537.03 |
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 $870.96 Median $912.01 Typical High $1,023.29 | Professional | None | $870.96 | $912.01 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,318.26 | Professional | None | $724.44 | $1,122.02 | $1,318.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $2,691.53 | Professional | None | $588.84 | $1,047.13 | $2,691.53 |
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 $616.60 Median $691.83 Typical High $1,174.90 | Professional | None | $616.60 | $691.83 | $1,174.90 |
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 $389.05 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $389.05 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $691.83 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 6.4 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 $13,837MT $2,168
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.