How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,230 to $19,953Professionalmedian $501 · 10th to 90th $363 to $1,175
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 $1,230.27 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,230.27 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,737.80 | Professional | None | $891.25 | $1,230.27 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,888.44 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,479.11 | Professional | None | $812.83 | $1,174.90 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $616.60 | Professional | None | $354.81 | $478.63 | $616.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,135.61 Median $19,054.61 Typical High $27,542.29 | Facility | None | $15,135.61 | $19,054.61 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,621.81 | Professional | None | $870.96 | $1,023.29 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $2,290.87 | Professional | None | $549.54 | $1,047.13 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,584.89 | Professional | None | $724.44 | $977.24 | $1,584.89 |
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 $446.68 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $177.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $660.69 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $131.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $616.60 | $870.96 | $870.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $22,387.21 Median $28,840.32 Typical High $41,686.94 | Facility | 50 · Both sides | $22,387.21 | $28,840.32 | $41,686.94 |
Where Utah sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.