How much rates vary
Facilitymedian $3,162 · 10th to 90th $355 to $5,012Professionalmedian $166 · 10th to 90th $123 to $347
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 $354.81 Median $3,388.44 Typical High $6,025.60 | Facility | None | $354.81 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $354.81 | Professional | None | $208.93 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,023.29 | $1,071.52 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $478.63 | Professional | None | $229.09 | $338.84 | $478.63 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $169.82 | Professional | None | $123.03 | $141.25 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $5,623.41 | Facility | None | $2,951.21 | $3,890.45 | $5,623.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $389.05 | Professional | None | $245.47 | $288.40 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $467.74 | Professional | None | $208.93 | $398.11 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $524.81 | Professional | None | $186.21 | $288.40 | $524.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $426.58 | Professional | None | $190.55 | $229.09 | $426.58 |
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 $104.71 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $104.71 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $41.69 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.89 | $35.48 | $35.48 |
Where Utah sits
The same service costs 6.8 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 $4,179MT $618
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.