How much rates vary
Facilitymedian $3,311 · 10th to 90th $309 to $6,918Professionalmedian $339 · 10th to 90th $30 to $501
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 $309.03 Median $2,884.03 Typical High $4,786.30 | Facility | None | $309.03 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $478.63 | Professional | None | $288.40 | $363.08 | $478.63 |
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 $363.08 Median $478.63 Typical High $575.44 | Professional | None | $363.08 | $478.63 | $575.44 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $295.12 Typical High $389.05 | Professional | None | $26.30 | $295.12 | $389.05 |
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 $309.03 Median $426.58 Typical High $501.19 | Professional | None | $309.03 | $426.58 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $371.54 | Professional | None | $309.03 | $331.13 | $371.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $741.31 | Professional | None | $288.40 | $478.63 | $741.31 |
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 $281.84 Median $389.05 Typical High $588.84 | Professional | None | $281.84 | $389.05 | $588.84 |
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 $147.91 Median $177.83 Typical High $208.93 | Professional | 52 · Reduced service | $147.91 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $58.88 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $218.78 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $43.65 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $295.12 |
Where Utah sits
The same service costs 6.1 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 $6,346MT $1,043
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.