How much rates vary
Facilitymedian $4,169 · 10th to 90th $513 to $8,511Professionalmedian $363 · 10th to 90th $30 to $589
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 $512.86 Median $3,162.28 Typical High $8,511.38 | Facility | None | $512.86 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $758.58 | Professional | None | $398.11 | $512.86 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $645.65 | Professional | None | $446.68 | $602.56 | $645.65 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $316.23 Typical High $489.78 | Professional | None | $28.18 | $316.23 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $794.33 | Professional | None | $457.09 | $676.08 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $676.08 | Professional | None | $389.05 | $575.44 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,230.27 | Professional | None | $457.09 | $724.44 | $1,230.27 |
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 $331.13 Median $501.19 Typical High $794.33 | Professional | None | $331.13 | $501.19 | $794.33 |
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 $257.04 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $151.36 | Professional | 53 · Discontinued | $102.33 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $389.05 | $389.05 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $75.86 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $524.81 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 4.7 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 $6,438MT $1,383
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.