How much rates vary
Facilitymedian $5,370 · 10th to 90th $851 to $13,804Professionalmedian $447 · 10th to 90th $55 to $776
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 $851.14 Median $4,570.88 Typical High $8,912.51 | Facility | None | $851.14 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $851.14 | Professional | None | $630.96 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,071.52 | Professional | None | $741.31 | $794.33 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $436.52 Typical High $562.34 | Professional | None | $54.95 | $436.52 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $12,022.64 Typical High $17,378.01 | Facility | None | $9,120.11 | $12,022.64 | $17,378.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,071.52 | Professional | None | $812.83 | $933.25 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,258.93 | Professional | None | $691.83 | $1,071.52 | $1,258.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $512.86 Median $912.01 Typical High $1,778.28 | Professional | None | $512.86 | $912.01 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $5,370.32 Typical High $13,803.84 | Facility | None | $1,698.24 | $5,370.32 | $13,803.84 |
United Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,174.90 | Professional | None | $575.44 | $645.65 | $1,174.90 |
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 $323.59 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $602.56 | $602.56 |
Where Utah sits
The same service costs 5.4 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 $11,084MT $2,070
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.