How much rates vary
Facilitymedian $6,026 · 10th to 90th $759 to $15,849Professionalmedian $355 · 10th to 90th $56 to $646
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 $758.58 Median $4,570.88 Typical High $8,912.51 | Facility | None | $758.58 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | None | $537.03 | $758.58 | $758.58 |
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 $630.96 Median $645.65 Typical High $776.25 | Professional | None | $630.96 | $645.65 | $776.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $331.13 Typical High $457.09 | Professional | None | $54.95 | $331.13 | $457.09 |
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 $691.83 Median $741.31 Typical High $812.83 | Professional | None | $691.83 | $741.31 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,071.52 | Professional | None | $588.84 | $912.01 | $1,071.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $1,862.09 | Professional | None | $501.19 | $851.14 | $1,862.09 |
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 $467.74 Median $549.54 Typical High $933.25 | Professional | None | $467.74 | $549.54 | $933.25 |
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 $309.03 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $537.03 |
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 7.9 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 $13,941MT $1,762
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.