How much rates vary
Facilitymedian $5,129 · 10th to 90th $871 to $15,488Professionalmedian $355 · 10th to 90th $59 to $603
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 $870.96 Median $4,570.88 Typical High $8,912.51 | Facility | None | $870.96 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | None | $602.56 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $891.25 | Professional | None | $707.95 | $758.58 | $891.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $338.84 Typical High $489.78 | Professional | None | $56.23 | $338.84 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
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 $1,047.13 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 $660.69 Median $954.99 Typical High $1,122.02 | Professional | None | $660.69 | $954.99 | $1,122.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,949.84 | Professional | None | $549.54 | $1,000.00 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $1,023.29 | Professional | None | $524.81 | $616.60 | $1,023.29 |
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 $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $616.60 | $616.60 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 5.6 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 $11,084MT $1,977
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.