How much rates vary
Facilitymedian $2,951 · 10th to 90th $174 to $4,677Professionalmedian $174 · 10th to 90th $132 to $275
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 $173.78 Median $2,951.21 Typical High $4,570.88 | Facility | None | $173.78 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $239.88 | Professional | None | $141.25 | $190.55 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,288.25 | $1,348.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $323.59 | Professional | None | $165.96 | $223.87 | $323.59 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $199.53 | Professional | None | $125.89 | $162.18 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $5,495.41 | Facility | None | $3,019.95 | $3,801.89 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $288.40 | Professional | None | $165.96 | $234.42 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $354.81 | Professional | None | $138.04 | $245.47 | $354.81 |
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 $131.83 Median $186.21 Typical High $331.13 | Professional | None | $131.83 | $186.21 | $331.13 |
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 $87.10 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $87.10 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $34.67 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $128.82 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $25.70 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $120.23 | $134.90 | $169.82 |
Where Utah sits
The same service costs 9.9 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 $4,605MT $466
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.