How much rates vary
Facilitymedian $3,090 · 10th to 90th $204 to $6,026Professionalmedian $138 · 10th to 90th $100 to $295
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 $204.17 Median $3,388.44 Typical High $6,025.60 | Facility | None | $204.17 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $234.42 | Professional | None | $181.97 | $204.17 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,023.29 | Facility | None | $954.99 | $1,000.00 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $354.81 | Professional | None | $199.53 | $223.87 | $354.81 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $138.04 | Professional | None | $97.72 | $114.82 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $5,128.61 | Facility | None | $2,754.23 | $3,548.13 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $295.12 | Professional | None | $208.93 | $245.47 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $338.84 | Professional | None | $125.89 | $234.42 | $338.84 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $8,912.51 | Facility | None | $302.00 | $1,698.24 | $8,912.51 |
United Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $354.81 | Professional | None | $154.88 | $190.55 | $354.81 |
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 $91.20 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $20.42 |
Where Utah sits
The same service costs 9.2 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 $4,822MT $526
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.