How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $4,786Professionalmedian $324 · 10th to 90th $30 to $537
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 $537.03 Median $2,884.03 Typical High $4,786.30 | Facility | None | $537.03 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $575.44 | Professional | None | $426.58 | $537.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $562.34 | Professional | None | $457.09 | $478.63 | $562.34 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $275.42 Typical High $426.58 | Professional | None | $28.18 | $275.42 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $676.08 | Professional | None | $524.81 | $602.56 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $870.96 | Professional | None | $436.52 | $741.31 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $977.24 | Professional | None | $380.19 | $691.83 | $977.24 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $676.08 | Professional | None | $346.74 | $407.38 | $676.08 |
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 $229.09 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $398.11 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 4.5 times more in Vermont than in Florida. 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 $4,521FL $1,007
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.