How much rates vary
Facilitymedian $6,026 · 10th to 90th $933 to $15,849Professionalmedian $380 · 10th to 90th $59 to $692
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 $933.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $933.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $954.99 | Professional | None | $660.69 | $933.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,248.07 | $5,495.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $562.34 | Professional | None | $56.23 | $363.08 | $562.34 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $2,290.87 | Professional | None | $588.84 | $1,047.13 | $2,290.87 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,148.15 | Professional | None | $575.44 | $676.08 | $1,148.15 |
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 $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $645.65 |
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 $13,816MT $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.