How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,047 to $15,488Professionalmedian $407 · 10th to 90th $59 to $759
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 $1,047.13 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,047.13 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,148.15 | Professional | None | $724.44 | $1,047.13 | $1,148.15 |
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 $891.25 Median $912.01 Typical High $1,071.52 | Professional | None | $891.25 | $912.01 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $389.05 Typical High $588.84 | Professional | None | $56.23 | $389.05 | $588.84 |
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 $954.99 Median $1,000.00 Typical High $1,122.02 | Professional | None | $954.99 | $1,000.00 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,479.11 | Professional | None | $794.33 | $1,258.93 | $1,479.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $676.08 Median $1,230.27 Typical High $2,238.72 | Professional | None | $676.08 | $1,230.27 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,258.93 | Professional | None | $630.96 | $758.58 | $1,258.93 |
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 $426.58 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $741.31 | $741.31 |
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 5.7 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 $13,613MT $2,377
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.