How much rates vary
Facilitymedian $3,715 · 10th to 90th $490 to $7,079Professionalmedian $295 · 10th to 90th $30 to $501
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 $489.78 Median $3,388.44 Typical High $6,025.60 | Facility | None | $489.78 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $691.83 | Professional | None | $446.68 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,737.80 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $831.76 | Professional | None | $501.19 | $524.81 | $831.76 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $263.03 Typical High $407.38 | Professional | None | $28.18 | $263.03 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $776.25 | Professional | None | $588.84 | $691.83 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $851.14 | Professional | None | $316.23 | $630.96 | $851.14 |
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 $416.87 Median $467.74 Typical High $912.01 | Professional | None | $416.87 | $467.74 | $912.01 |
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 $239.88 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $346.74 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,413.10 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 3.6 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 $5,175MT $1,450
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.