How much rates vary
Facilitymedian $3,311 · 10th to 90th $288 to $6,026Professionalmedian $316 · 10th to 90th $240 to $501
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 $288.40 Median $2,884.03 Typical High $4,786.30 | Facility | None | $288.40 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $398.11 | Professional | None | $204.17 | $309.03 | $398.11 |
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 $263.03 Median $363.08 Typical High $575.44 | Professional | None | $263.03 | $363.08 | $575.44 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $346.74 | Professional | None | $239.88 | $281.84 | $346.74 |
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 $251.19 Median $416.87 Typical High $524.81 | Professional | None | $251.19 | $416.87 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $588.84 | Professional | None | $208.93 | $436.52 | $588.84 |
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 $204.17 Median $323.59 Typical High $588.84 | Professional | None | $204.17 | $323.59 | $588.84 |
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 $128.82 Median $154.88 Typical High $194.98 | Professional | 52 · Reduced service | $128.82 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $190.55 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.70 | $30.90 | $38.90 |
Where Utah sits
The same service costs 7.9 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 $5,867MT $745
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.