How much rates vary
Facilitymedian $4,169 · 10th to 90th $372 to $8,511Professionalmedian $240 · 10th to 90th $30 to $427
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 $371.54 Median $3,162.28 Typical High $8,511.38 | Facility | None | $371.54 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $549.54 | Professional | None | $269.15 | $371.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $478.63 | Professional | None | $323.59 | $446.68 | $478.63 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $213.80 Typical High $346.74 | Professional | None | $26.92 | $213.80 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $588.84 | Professional | None | $338.84 | $501.19 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $524.81 | Professional | None | $281.84 | $446.68 | $524.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $912.01 | Professional | None | $323.59 | $512.86 | $912.01 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $588.84 | Professional | None | $239.88 | $371.54 | $588.84 |
6 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 $186.21 Median $186.21 Typical High $275.42 | Professional | 52 · Reduced service | $186.21 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | 54 · Surgery only | $281.84 | $281.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $389.05 |
Where Utah sits
The same service costs 6.3 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 $6,296MT $1,002
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.