How much rates vary
Facilitymedian $4,169 · 10th to 90th $437 to $8,511Professionalmedian $302 · 10th to 90th $30 to $513
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 $436.52 Median $3,162.28 Typical High $8,511.38 | Facility | None | $436.52 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $630.96 | Professional | None | $338.84 | $436.52 | $630.96 |
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 $380.19 Median $512.86 Typical High $549.54 | Professional | None | $380.19 | $512.86 | $549.54 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $269.15 Typical High $416.87 | Professional | None | $28.18 | $269.15 | $416.87 |
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 $407.38 Median $602.56 Typical High $707.95 | Professional | None | $407.38 | $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 $346.74 Median $512.86 Typical High $602.56 | Professional | None | $346.74 | $512.86 | $602.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,202.26 | Professional | None | $407.38 | $691.83 | $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 $288.40 Median $436.52 Typical High $691.83 | Professional | None | $288.40 | $436.52 | $691.83 |
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 $218.78 Median $218.78 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $125.89 | Professional | 53 · Discontinued | $87.10 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $467.74 | Professional | 54 · Surgery only | $323.59 | $323.59 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $93.33 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $436.52 |
Where Utah sits
The same service costs 11.0 times more in Vermont 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
VT $12,892MT $1,170
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.