How much rates vary
Facilitymedian $3,311 · 10th to 90th $525 to $7,079Professionalmedian $324 · 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 $524.81 Median $2,884.03 Typical High $4,786.30 | Facility | None | $524.81 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $812.83 | Professional | None | $407.38 | $524.81 | $812.83 |
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 $436.52 Median $588.84 Typical High $676.08 | Professional | None | $436.52 | $588.84 | $676.08 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $281.84 Typical High $478.63 | Professional | None | $28.18 | $281.84 | $478.63 |
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 $436.52 Median $660.69 Typical High $776.25 | Professional | None | $436.52 | $660.69 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $676.08 | Professional | None | $363.08 | $575.44 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $1,258.93 | Professional | None | $446.68 | $741.31 | $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 $346.74 Median $549.54 Typical High $851.14 | Professional | None | $346.74 | $549.54 | $851.14 |
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 $263.03 Median $263.03 Typical High $398.11 | Professional | 52 · Reduced service | $263.03 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $162.18 | Professional | 53 · Discontinued | $104.71 | $104.71 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $602.56 | Professional | 54 · Surgery only | $389.05 | $389.05 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $120.23 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $79.43 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $562.34 |
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 4.4 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 $6,451MT $1,460
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.