How much rates vary
Facilitymedian $6,026 · 10th to 90th $871 to $15,849Professionalmedian $355 · 10th to 90th $59 to $661
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 $870.96 Median $4,570.88 Typical High $8,912.51 | Facility | None | $870.96 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
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 $741.31 Median $741.31 Typical High $891.25 | Professional | None | $741.31 | $741.31 | $891.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $331.13 Typical High $524.81 | Professional | None | $56.23 | $331.13 | $524.81 |
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 $812.83 Median $851.14 Typical High $954.99 | Professional | None | $812.83 | $851.14 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,230.27 | Professional | None | $676.08 | $1,071.52 | $1,230.27 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $2,137.96 | Professional | None | $575.44 | $977.24 | $2,137.96 |
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 $537.03 Median $630.96 Typical High $1,047.13 | Professional | None | $537.03 | $630.96 | $1,047.13 |
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 $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $602.56 |
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 6.8 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 $13,753MT $2,023
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.