How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $4,571Professionalmedian $324 · 10th to 90th $30 to $525
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 $537.03 Median $2,951.21 Typical High $4,570.88 | Facility | None | $537.03 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $575.44 | Professional | None | $416.87 | $537.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $562.34 | Professional | None | $457.09 | $489.78 | $562.34 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $275.42 Typical High $407.38 | Professional | None | $28.18 | $275.42 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $676.08 | Professional | None | $524.81 | $602.56 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $851.14 | Professional | None | $436.52 | $724.44 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,023.29 | Professional | None | $389.05 | $691.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $676.08 | Professional | None | $338.84 | $416.87 | $676.08 |
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 $234.42 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $346.74 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $407.38 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 4.7 times more in Colorado than in Delaware. 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 $4,364DE $926
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.