How much rates vary
Facilitymedian $3,162 · 10th to 90th $479 to $6,026Professionalmedian $776 · 10th to 90th $115 to $1,072
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 $478.63 Median $2,951.21 Typical High $4,570.88 | Facility | None | $478.63 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $912.01 | Professional | None | $478.63 | $562.34 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,148.15 | Facility | None | $1,071.52 | $1,122.02 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $794.33 | Professional | None | $416.87 | $676.08 | $794.33 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $776.25 Typical High $1,023.29 | Professional | None | $109.65 | $776.25 | $1,023.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,162.28 | $3,981.07 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,659.59 | Professional | None | $676.08 | $1,000.00 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $707.95 | Professional | None | $457.09 | $602.56 | $707.95 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $2,137.96 | Professional | None | $537.03 | $1,071.52 | $2,137.96 |
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 $323.59 Median $549.54 Typical High $933.25 | Professional | None | $323.59 | $549.54 | $933.25 |
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 $239.88 Median $275.42 Typical High $446.68 | Professional | 52 · Reduced service | $239.88 | $275.42 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $112.20 Typical High $181.97 | Professional | 53 · Discontinued | $95.50 | $112.20 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $676.08 | Professional | 54 · Surgery only | $363.08 | $416.87 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $134.90 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $91.20 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $389.05 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $338.84 | $389.05 | $630.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $6,025.60 Typical High $8,709.64 | Facility | 50 · Both sides | $4,786.30 | $6,025.60 | $8,709.64 |
Where Utah sits
The same service costs 3.2 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 $4,968MT $1,567
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.