How much rates vary
Facilitymedian $3,311 · 10th to 90th $457 to $7,079Professionalmedian $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 $457.09 Median $2,884.03 Typical High $4,786.30 | Facility | None | $457.09 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $645.65 | Professional | None | $363.08 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $562.34 | Professional | None | $398.11 | $537.03 | $562.34 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $275.42 Typical High $446.68 | Professional | None | $28.18 | $275.42 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $707.95 | Professional | None | $416.87 | $602.56 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $602.56 | Professional | None | $354.81 | $512.86 | $602.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,202.26 | Professional | None | $407.38 | $660.69 | $1,202.26 |
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 $302.00 Median $446.68 Typical High $707.95 | Professional | None | $302.00 | $446.68 | $707.95 |
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 $229.09 Median $229.09 Typical High $323.59 | Professional | 52 · Reduced service | $229.09 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $128.82 | Professional | 53 · Discontinued | $91.20 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $446.68 |
Where Utah sits
The same service costs 5.3 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 $6,378MT $1,213
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.