How much rates vary
Facilitymedian $2,512 · 10th to 90th $550 to $4,571Professionalmedian $347 · 10th to 90th $30 to $550
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 $549.54 Median $2,951.21 Typical High $4,570.88 | Facility | None | $549.54 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $602.56 | Professional | None | $489.78 | $549.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $588.84 | Professional | None | $457.09 | $501.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $302.00 Typical High $436.52 | Professional | None | $28.18 | $302.00 | $436.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $724.44 | Professional | None | $549.54 | $645.65 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $870.96 | Professional | None | $467.74 | $758.58 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $707.95 Typical High $1,023.29 | Professional | None | $407.38 | $707.95 | $1,023.29 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $691.83 | Professional | None | $346.74 | $436.52 | $691.83 |
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 $245.47 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $426.58 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 5.3 times more in Colorado than in Florida. 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 $4,377FL $831
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.