How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,023 to $15,849Professionalmedian $407 · 10th to 90th $59 to $724
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 $1,023.29 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,023.29 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | None | $741.31 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $6,165.95 | Facility | None | $5,888.44 | $6,165.95 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,047.13 | Professional | None | $870.96 | $891.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $389.05 Typical High $562.34 | Professional | None | $56.23 | $389.05 | $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 $933.25 Median $1,000.00 Typical High $1,096.48 | Professional | None | $933.25 | $1,000.00 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,412.54 | Professional | None | $794.33 | $1,202.26 | $1,412.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $2,454.71 | Professional | None | $645.65 | $1,122.02 | $2,454.71 |
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 $630.96 Median $741.31 Typical High $1,258.93 | Professional | None | $630.96 | $741.31 | $1,258.93 |
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 $416.87 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $724.44 |
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 6.2 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 $14,513MT $2,350
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.