How much rates vary
Facilitymedian $2,291 · 10th to 90th $355 to $4,677Professionalmedian $229 · 10th to 90th $174 to $363
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 $251.19 Median $354.81 Typical High $389.05 | Professional | None | $251.19 | $354.81 | $389.05 |
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 $263.03 Median $363.08 Typical High $478.63 | Professional | None | $263.03 | $363.08 | $478.63 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | None | $169.82 | $194.98 | $234.42 |
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 $309.03 Median $346.74 Typical High $407.38 | Professional | None | $309.03 | $346.74 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $588.84 | Professional | None | $263.03 | $489.78 | $588.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $512.86 | Professional | None | $245.47 | $354.81 | $512.86 |
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 $234.42 Median $263.03 Typical High $478.63 | Professional | None | $234.42 | $263.03 | $478.63 |
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 $131.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $199.53 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.30 | $35.48 | $35.48 |
Where Utah sits
The same service costs 5.6 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 $4,320MT $769
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.