How much rates vary
Facilitymedian $6,310 · 10th to 90th $776 to $15,849Professionalmedian $339 · 10th to 90th $59 to $631
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 $776.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $776.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $6,025.60 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,025.60 | $6,309.57 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $323.59 Typical High $501.19 | Professional | None | $56.23 | $323.59 | $501.19 |
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 $794.33 Median $831.76 Typical High $933.25 | Professional | None | $794.33 | $831.76 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,230.27 | Professional | None | $660.69 | $1,047.13 | $1,230.27 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,737.80 | Professional | None | $562.34 | $1,000.00 | $1,737.80 |
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 $501.19 Median $602.56 Typical High $1,023.29 | Professional | None | $501.19 | $602.56 | $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 $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $549.54 |
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 7.1 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 $14,034MT $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.