How much rates vary
Facilitymedian $2,951 · 10th to 90th $417 to $4,571Professionalmedian $209 · 10th to 90th $30 to $389
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 $446.68 Median $3,162.28 Typical High $4,570.88 | Facility | None | $446.68 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | None | $363.08 | $446.68 | $446.68 |
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 $363.08 Median $363.08 Typical High $478.63 | Professional | None | $363.08 | $363.08 | $478.63 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $190.55 Typical High $338.84 | Professional | None | $28.18 | $190.55 | $338.84 |
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 $467.74 Median $501.19 Typical High $549.54 | Professional | None | $467.74 | $501.19 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $758.58 | Professional | None | $389.05 | $645.65 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $891.25 | Professional | None | $309.03 | $575.44 | $891.25 |
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 $281.84 Median $338.84 Typical High $588.84 | Professional | None | $281.84 | $338.84 | $588.84 |
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 $204.17 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $309.03 |
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 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.