How much rates vary
Facilitymedian $3,020 · 10th to 90th $372 to $6,166Professionalmedian $363 · 10th to 90th $30 to $575
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 $371.54 Median $2,951.21 Typical High $4,570.88 | Facility | None | $371.54 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $575.44 | Professional | None | $331.13 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,479.11 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $794.33 | Professional | None | $389.05 | $524.81 | $794.33 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $323.59 Typical High $446.68 | Professional | None | $26.92 | $323.59 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,888.44 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $724.44 | Professional | None | $416.87 | $588.84 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $912.01 | Professional | None | $338.84 | $602.56 | $912.01 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $812.83 | Professional | None | $323.59 | $457.09 | $812.83 |
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 $186.21 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $186.21 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $74.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $281.84 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $56.23 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $37.15 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $263.03 | $309.03 | $363.08 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,606.93 Median $8,912.51 Typical High $12,882.50 | Facility | 50 · Both sides | $6,606.93 | $8,912.51 | $12,882.50 |
Where Utah sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.