How much rates vary
Facilitymedian $3,311 · 10th to 90th $186 to $6,918Professionalmedian $224 · 10th to 90th $30 to $331
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 $186.21 Median $2,884.03 Typical High $4,786.30 | Facility | None | $186.21 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $346.74 | Professional | None | $177.83 | $239.88 | $346.74 |
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 $213.80 Median $275.42 Typical High $363.08 | Professional | None | $213.80 | $275.42 | $363.08 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $199.53 Typical High $288.40 | Professional | None | $26.30 | $199.53 | $288.40 |
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 $190.55 Median $281.84 Typical High $331.13 | Professional | None | $190.55 | $281.84 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $251.19 | Professional | None | $190.55 | $223.87 | $251.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $316.23 Typical High $489.78 | Professional | None | $162.18 | $316.23 | $489.78 |
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 $169.82 Median $234.42 Typical High $371.54 | Professional | None | $169.82 | $234.42 | $371.54 |
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 $91.20 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $91.20 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $36.31 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $138.04 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $128.82 | $158.49 | $186.21 |
Where Utah sits
The same service costs 9.3 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 $5,912MT $637
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.