How much rates vary
Facilitymedian $2,291 · 10th to 90th $324 to $4,571Professionalmedian $132 · 10th to 90th $100 to $309
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 $323.59 Median $3,162.28 Typical High $4,570.88 | Facility | None | $323.59 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $323.59 | Professional | None | $173.78 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $794.33 | Facility | None | $741.31 | $776.25 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $323.59 | Professional | None | $204.17 | $309.03 | $323.59 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $138.04 | Professional | None | $97.72 | $112.20 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $3,548.13 | Facility | None | $1,905.46 | $2,454.71 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $275.42 | Professional | None | $208.93 | $234.42 | $275.42 |
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 $177.83 Median $275.42 Typical High $331.13 | Professional | None | $177.83 | $275.42 | $331.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $346.74 | Professional | None | $158.49 | $234.42 | $346.74 |
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 $154.88 Median $186.21 Typical High $363.08 | Professional | None | $154.88 | $186.21 | $363.08 |
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 $87.10 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $87.10 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $131.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $26.30 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $32.36 | $32.36 |
Where Utah sits
The same service costs 7.7 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 $4,047MT $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.