How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,230 to $15,488Professionalmedian $537 · 10th to 90th $87 to $933
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 $1,230.27 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,230.27 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,230.27 | Professional | None | $954.99 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,023.29 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $501.19 Typical High $758.58 | Professional | None | $85.11 | $501.19 | $758.58 |
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 $1,148.15 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,230.27 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,862.09 | Professional | None | $954.99 | $1,584.89 | $1,862.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $2,187.76 | Professional | None | $812.83 | $1,412.54 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,548.82 | Professional | None | $758.58 | $891.25 | $1,548.82 |
6 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 $524.81 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $851.14 |
Where Utah sits
The same service costs 4.2 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 $12,508MT $2,994
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.