How much rates vary
Facilitymedian $3,388 · 10th to 90th $282 to $7,413Professionalmedian $174 · 10th to 90th $126 to $347
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 $281.84 Median $3,162.28 Typical High $4,570.88 | Facility | None | $281.84 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | None | $218.78 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,949.84 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | None | $251.19 | $281.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $173.78 | Professional | None | $123.03 | $141.25 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,623.41 Median $7,079.46 Typical High $10,232.93 | Facility | None | $5,623.41 | $7,079.46 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $338.84 | Professional | None | $263.03 | $309.03 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $144.54 Median $309.03 Typical High $426.58 | Professional | None | $144.54 | $309.03 | $426.58 |
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 $194.98 Median $245.47 Typical High $436.52 | Professional | None | $194.98 | $245.47 | $436.52 |
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 $109.65 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $162.18 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $32.36 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $151.36 | $194.98 | $194.98 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,317.64 Median $10,715.19 Typical High $15,488.17 | Facility | 50 · Both sides | $8,317.64 | $10,715.19 | $15,488.17 |
Where Utah sits
The same service costs 9.6 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 $6,197MT $647
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.