How much rates vary
Facilitymedian $2,818 · 10th to 90th $646 to $4,786Professionalmedian $398 · 10th to 90th $59 to $692
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 $954.99 Median $3,388.44 Typical High $6,025.60 | Facility | None | $954.99 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $891.25 | Facility | None | $851.14 | $870.96 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $562.34 | Professional | None | $56.23 | $363.08 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,570.40 | $3,311.31 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,047.13 | Professional | None | $891.25 | $954.99 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,380.38 | Professional | None | $758.58 | $1,174.90 | $1,380.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,621.81 | Professional | None | $588.84 | $1,148.15 | $1,621.81 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,202.26 | Professional | None | $588.84 | $707.95 | $1,202.26 |
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 $407.38 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $575.44 | $660.69 | $660.69 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $5,011.87 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $5,011.87 | $7,244.36 |
Where Utah sits
The same service costs 3.6 times more in Colorado than in Delaware. 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 $4,868DE $1,354
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.