How much rates vary
Facilitymedian $5,129 · 10th to 90th $447 to $8,913Professionalmedian $257 · 10th to 90th $60 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 $446.68 Median $4,570.88 Typical High $8,912.51 | Facility | None | $446.68 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $724.44 | Professional | None | $338.84 | $446.68 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $630.96 | Professional | None | $389.05 | $446.68 | $630.96 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $234.42 Typical High $295.12 | Professional | None | $33.88 | $234.42 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $10,471.29 | Facility | None | $5,754.40 | $7,244.36 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | None | $426.58 | $501.19 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $234.42 Median $501.19 Typical High $977.24 | Professional | None | $234.42 | $501.19 | $977.24 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $691.83 | Professional | None | $316.23 | $389.05 | $691.83 |
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 $177.83 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $316.23 |
Where Utah sits
The same service costs 7.8 times more in Vermont 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
VT $8,433MT $1,087
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.