How much rates vary
Facilitymedian $2,951 · 10th to 90th $62 to $4,571Professionalmedian $49 · 10th to 90th $26 to $65
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 $61.66 Median $3,162.28 Typical High $4,570.88 | Facility | None | $61.66 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $61.66 | Professional | None | $40.74 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $72.44 | Professional | None | $45.71 | $61.66 | $72.44 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $34.67 | Professional | None | $25.12 | $28.84 | $34.67 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $64.57 | Professional | None | $48.98 | $54.95 | $64.57 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Select Health Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $75.86 | Professional | None | $41.69 | $64.57 | $75.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $81.28 | Professional | None | $36.31 | $54.95 | $81.28 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $81.28 | Professional | None | $36.31 | $42.66 | $81.28 |
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 $19.95 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $19.95 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $8.13 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $46.77 Typical High $46.77 | Professional | 54 · Surgery only | $30.20 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $6.03 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.07 | $6.17 | $6.17 |
Where Utah sits
The same service costs 24.6 times more in Utah 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
UT $3,000MT $122
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.