How much rates vary
Facilitymedian $78 · 10th to 90th $68 to $4,571Professionalmedian $76 · 10th to 90th $45 to $93
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 $72.44 Median $3,162.28 Typical High $6,025.60 | Facility | None | $72.44 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $72.44 Typical High $77.62 | Professional | None (both parts) | $69.18 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | 26 · Professional part | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | TC · Technical part | $41.69 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $30.20 | $44.67 | $44.67 |
Regence BlueShield Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $112.20 | Facility | None | $61.66 | $77.62 | $112.20 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $72.44 Median $75.86 Typical High $85.11 | Professional | None (both parts) | $72.44 | $75.86 | $85.11 |
Regence BlueShield Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $28.84 Typical High $32.36 | Professional | 26 · Professional part | $27.54 | $28.84 | $32.36 |
Regence BlueShield Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $47.86 Typical High $52.48 | Professional | TC · Technical part | $44.67 | $47.86 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Select Health Setting Professional Modifier None (both parts) Typical Low $34.67 Median $38.02 Typical High $5,011.87 | Professional | None (both parts) | $34.67 | $38.02 | $5,011.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.88 Median $54.95 Typical High $100.00 | Professional | None | $33.88 | $54.95 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $67.61 Median $81.28 Typical High $112.20 | Professional | None (both parts) | $67.61 | $81.28 | $112.20 |
United Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $30.90 Typical High $45.71 | Professional | 26 · Professional part | $26.92 | $30.90 | $45.71 |
United Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $47.86 Typical High $69.18 | Professional | TC · Technical part | $40.74 | $47.86 | $69.18 |
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 $34.67 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $34.67 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $15.49 | Professional | 53 · Discontinued | $13.80 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | 54 · Surgery only | $52.48 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $11.75 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $7.76 |
Where Utah sits
The same service costs 4.4 times more in Texas than in New York. 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.
Utah· 29th of 51
$75.86
TX $174NY $39.81
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.