How much rates vary
Facilitymedian $3,467 · 10th to 90th $550 to $7,762Professionalmedian $331 · 10th to 90th $245 to $550
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 $549.54 Median $4,570.88 Typical High $8,912.51 | Facility | None | $549.54 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $549.54 | Professional | None | $371.54 | $549.54 | $549.54 |
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 $426.58 Median $537.03 Typical High $630.96 | Professional | None | $426.58 | $537.03 | $630.96 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $331.13 | Professional | None | $245.47 | $281.84 | $331.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $5,623.41 | Facility | None | $3,162.28 | $4,073.80 | $5,623.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $602.56 | Professional | None | $457.09 | $512.86 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $870.96 | Professional | None | $398.11 | $741.31 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $1,000.00 | Professional | None | $323.59 | $524.81 | $1,000.00 |
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 $346.74 Median $389.05 Typical High $724.44 | Professional | None | $346.74 | $389.05 | $724.44 |
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 $194.98 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $288.40 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $57.54 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $54.95 | $54.95 |
Where Utah sits
The same service costs 5.0 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 $5,749MT $1,151
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.