How much rates vary
Facilitymedian $3,311 · 10th to 90th $575 to $6,918Professionalmedian $389 · 10th to 90th $63 to $646
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 $575.44 Median $2,884.03 Typical High $4,786.30 | Facility | None | $575.44 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $794.33 | Professional | None | $537.03 | $575.44 | $794.33 |
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 $501.19 Median $660.69 Typical High $691.83 | Professional | None | $501.19 | $660.69 | $691.83 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $346.74 Typical High $537.03 | Professional | None | $56.23 | $346.74 | $537.03 |
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 $524.81 Median $724.44 Typical High $870.96 | Professional | None | $524.81 | $724.44 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $758.58 | Professional | None | $446.68 | $645.65 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,258.93 | Professional | None | $512.86 | $794.33 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $831.76 | Professional | None | $371.54 | $537.03 | $831.76 |
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 $288.40 Median $288.40 Typical High $389.05 | Professional | 52 · Reduced service | $288.40 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | 53 · Discontinued | $114.82 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $436.52 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $79.43 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $549.54 |
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 4.4 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 $6,491MT $1,489
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.