How much rates vary
Facilitymedian $3,715 · 10th to 90th $407 to $7,943Professionalmedian $234 · 10th to 90th $186 to $437
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 $407.38 Median $4,570.88 Typical High $9,120.11 | Facility | None | $407.38 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $575.44 | Professional | None | $295.12 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,202.26 | Facility | None | $1,148.15 | $1,174.90 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $575.44 | Professional | None | $346.74 | $380.19 | $575.44 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $263.03 | Professional | None | $173.78 | $218.78 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,235.94 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $537.03 | Professional | None | $371.54 | $436.52 | $537.03 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $1,202.26 | Professional | None | $204.17 | $446.68 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $602.56 | Professional | None | $275.42 | $331.13 | $602.56 |
6 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 $147.91 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $147.91 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $58.88 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $44.67 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $29.51 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $208.93 | $288.40 | $288.40 |
Where Utah sits
The same service costs 6.6 times more in Oklahoma 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
OK $6,126MT $925
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.