How much rates vary
Facilitymedian $3,715 · 10th to 90th $427 to $7,943Professionalmedian $257 · 10th to 90th $44 to $479
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 $426.58 Median $4,570.88 Typical High $9,120.11 | Facility | None | $426.58 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $616.60 | Professional | None | $331.13 | $426.58 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,202.26 | Facility | None | $1,148.15 | $1,174.90 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $602.56 | Professional | None | $371.54 | $426.58 | $602.56 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $234.42 Typical High $295.12 | Professional | None | $33.88 | $234.42 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,235.94 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $524.81 | Professional | None | $407.38 | $478.63 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $223.87 Median $478.63 Typical High $707.95 | Professional | None | $223.87 | $478.63 | $707.95 |
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 $302.00 Median $371.54 Typical High $660.69 | Professional | None | $302.00 | $371.54 | $660.69 |
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 $169.82 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $302.00 | $302.00 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $4,897.79 Median $6,309.57 Typical High $9,120.11 | Facility | 50 · Both sides | $4,897.79 | $6,309.57 | $9,120.11 |
Where Utah sits
The same service costs 5.1 times more in Oklahoma 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
OK $5,094MT $991
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.