How much rates vary
Facilitymedian $4,169 · 10th to 90th $417 to $9,333Professionalmedian $389 · 10th to 90th $65 to $646
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 $416.87 Median $3,162.28 Typical High $8,511.38 | Facility | None | $416.87 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $741.31 | Professional | None | $398.11 | $489.78 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,819.70 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $870.96 | Professional | None | $489.78 | $562.34 | $870.96 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $331.13 Typical High $501.19 | Professional | None | $56.23 | $331.13 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $11,481.54 | Facility | None | $5,888.44 | $7,943.28 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $870.96 | Professional | None | $537.03 | $660.69 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,023.29 | Professional | None | $389.05 | $691.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $4,168.69 Typical High $7,079.46 | Facility | None | $1,000.00 | $4,168.69 | $7,079.46 |
United Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $891.25 | Professional | None | $398.11 | $512.86 | $891.25 |
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 $208.93 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $295.12 | $338.84 | $346.74 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $11,748.98 Typical High $16,982.44 | Facility | 50 · Both sides | $8,709.64 | $11,748.98 | $16,982.44 |
Where Utah sits
The same service costs 7.2 times more in Vermont than in Maine. 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
VT $9,370ME $1,294
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.