How much rates vary
Facilitymedian $4,467 · 10th to 90th $891 to $7,943Professionalmedian $295 · 10th to 90th $224 to $759
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 $891.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $891.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $891.25 Typical High $891.25 | Professional | None | $346.74 | $891.25 | $891.25 |
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 $478.63 Median $758.58 Typical High $794.33 | Professional | None | $478.63 | $758.58 | $794.33 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $302.00 | Professional | None | $218.78 | $251.19 | $302.00 |
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 $426.58 Median $457.09 Typical High $501.19 | Professional | None | $426.58 | $457.09 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $645.65 | Professional | None | $363.08 | $549.54 | $645.65 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $954.99 | Professional | None | $323.59 | $549.54 | $954.99 |
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 $467.74 Typical High $741.31 | Professional | None | $323.59 | $467.74 | $741.31 |
5 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 $257.04 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $257.04 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $102.33 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $389.05 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $77.62 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $51.29 | $89.13 | $89.13 |
Where Utah sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.