How much rates vary
Facilitymedian $2,570 · 10th to 90th $692 to $4,786Professionalmedian $380 · 10th to 90th $63 to $676
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 $691.83 Median $2,884.03 Typical High $4,786.30 | Facility | None | $691.83 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $758.58 | Professional | None | $501.19 | $691.83 | $758.58 |
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 $588.84 Median $645.65 Typical High $724.44 | Professional | None | $588.84 | $645.65 | $724.44 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $331.13 Typical High $501.19 | Professional | None | $56.23 | $331.13 | $501.19 |
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 $645.65 Median $758.58 Typical High $831.76 | Professional | None | $645.65 | $758.58 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,000.00 | Professional | None | $537.03 | $851.14 | $1,000.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,479.11 | Professional | None | $501.19 | $831.76 | $1,479.11 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $851.14 | Professional | None | $436.52 | $512.86 | $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 $281.84 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $489.78 | $524.81 |
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 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.