How much rates vary
Facilitymedian $4,467 · 10th to 90th $575 to $15,488Professionalmedian $417 · 10th to 90th $63 to $661
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 $575.44 Median $3,162.28 Typical High $8,709.64 | Facility | None | $575.44 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $831.76 | Professional | None | $407.38 | $575.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $724.44 | Professional | None | $501.19 | $676.08 | $724.44 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $549.54 | Professional | None | $56.23 | $363.08 | $549.54 |
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 $512.86 Median $758.58 Typical High $891.25 | Professional | None | $512.86 | $758.58 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $812.83 | Professional | None | $436.52 | $691.83 | $812.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $1,412.54 | Professional | None | $501.19 | $870.96 | $1,412.54 |
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 $371.54 Median $562.34 Typical High $870.96 | Professional | None | $371.54 | $562.34 | $870.96 |
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 $288.40 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $616.60 | Professional | 54 · Surgery only | $426.58 | $426.58 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $125.89 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $575.44 |
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 6.5 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 $9,949MT $1,532
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.