How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,514 to $13,804Professionalmedian $676 · 10th to 90th $83 to $1,288
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 $1,513.56 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,513.56 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,630.27 | Facility | None | $2,454.71 | $2,570.40 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,288.25 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $660.69 Typical High $831.76 | Professional | None | $83.18 | $660.69 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,471.29 Median $13,182.57 Typical High $19,054.61 | Facility | None | $10,471.29 | $13,182.57 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,778.28 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,698.24 | $1,995.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $2,511.89 | Professional | None | $912.01 | $1,659.59 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,819.70 | Professional | None | $891.25 | $1,071.52 | $1,819.70 |
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 $616.60 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $1,047.13 | $1,047.13 |
Where Utah sits
The same service costs 5.3 times more in Vermont than in Hawaii. 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 $13,652HI $2,577
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.