How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,175 to $13,804Professionalmedian $589 · 10th to 90th $85 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 $1,174.90 Median $4,570.88 Typical High $12,302.69 | Facility | None | $1,174.90 | $4,570.88 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,905.46 | Professional | None | $851.14 | $1,174.90 | $1,905.46 |
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 $1,047.13 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,122.02 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $549.54 Typical High $776.25 | Professional | None | $83.18 | $549.54 | $776.25 |
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 $1,122.02 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,318.26 | $1,548.82 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $645.65 Median $1,318.26 Typical High $2,398.83 | Professional | None | $645.65 | $1,318.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $6,918.31 Typical High $13,803.84 | Facility | None | $1,698.24 | $6,918.31 | $13,803.84 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,862.09 | Professional | None | $851.14 | $1,000.00 | $1,862.09 |
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 $426.58 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $426.58 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $169.82 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $812.83 | $812.83 |
Where Utah sits
The same service costs 4.2 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 $11,551MT $2,762
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.