How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $1,047 · 10th to 90th $141 to $1,995
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 $1,995.26 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,995.26 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,778.28 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,187.76 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $977.24 Typical High $1,380.38 | Professional | None | $138.04 | $977.24 | $1,380.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,398.83 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,348.96 | $2,398.83 | $3,890.45 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,819.70 | $3,467.37 |
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 $891.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $354.81 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,380.38 |
Where Utah sits
The same service costs 7.4 times more in Colorado than in Texas. 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 $16,853TX $2,277
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.