How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,660 to $15,849Professionalmedian $708 · 10th to 90th $112 to $1,148
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 $1,659.59 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,659.59 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,412.54 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $676.08 Typical High $933.25 | Professional | None | $109.65 | $676.08 | $933.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,862.09 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,174.90 | $2,398.83 | $2,818.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,000.00 | $1,778.28 | $3,801.89 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $15,848.93 | Facility | None | $2,398.83 | $4,897.79 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,174.90 | $1,995.26 |
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 $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $1,148.15 | $1,148.15 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 5.0 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 $14,731KY $2,968
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.