How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,318 to $21,878Professionalmedian $617 · 10th to 90th $50 to $1,230
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 $1,318.26 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,318.26 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $933.25 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $6,165.95 | Facility | None | $5,888.44 | $6,025.60 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,230.27 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $588.84 Typical High $776.25 | Professional | None | $48.98 | $588.84 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,848.93 Median $21,379.62 Typical High $27,542.29 | Facility | None | $15,848.93 | $21,379.62 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,348.96 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $630.96 Median $1,380.38 Typical High $3,162.28 | Professional | None | $630.96 | $1,380.38 | $3,162.28 |
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 $851.14 Median $1,071.52 Typical High $1,905.46 | Professional | None | $851.14 | $1,071.52 | $1,905.46 |
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 $467.74 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $467.74 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $186.21 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $707.95 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $660.69 | $912.01 | $912.01 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $23,988.33 Median $32,359.37 Typical High $40,738.03 | Facility | 50 · Both sides | $23,988.33 | $32,359.37 | $40,738.03 |
Where Utah sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.