How much rates vary
Facilitymedian $4,467 · 10th to 90th $832 to $7,943Professionalmedian $347 · 10th to 90th $59 to $631
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 $831.76 Median $4,570.88 Typical High $8,912.51 | Facility | None | $831.76 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $831.76 | Professional | None | $588.84 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,479.11 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | None | $691.83 | $691.83 | $851.14 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $331.13 Typical High $512.86 | Professional | None | $56.23 | $331.13 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,888.44 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $912.01 | Professional | None | $776.25 | $831.76 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,230.27 | Professional | None | $660.69 | $1,047.13 | $1,230.27 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,412.54 | Professional | None | $512.86 | $1,000.00 | $1,412.54 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,047.13 | Professional | None | $489.78 | $616.60 | $1,047.13 |
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 $346.74 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $588.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,606.93 Median $8,912.51 Typical High $12,882.50 | Facility | 50 · Both sides | $6,606.93 | $8,912.51 | $12,882.50 |
Where Utah sits
The same service costs 4.6 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 $6,475DE $1,401
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.