How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,202 to $15,849Professionalmedian $501 · 10th to 90th $59 to $891
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 $1,202.26 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,202.26 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,348.96 | Professional | None | $851.14 | $1,202.26 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,495.41 | $5,754.40 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $478.63 Typical High $707.95 | Professional | None | $56.23 | $478.63 | $707.95 |
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 $1,096.48 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,174.90 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $933.25 | $1,479.11 | $1,737.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,348.96 Typical High $3,019.95 | Professional | None | $776.25 | $1,348.96 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,479.11 | Professional | None | $724.44 | $870.96 | $1,479.11 |
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 $501.19 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $831.76 |
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 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.