How much rates vary
Facilitymedian $3,162 · 10th to 90th $851 to $4,898Professionalmedian $525 · 10th to 90th $65 to $977
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 $851.14 Median $3,388.44 Typical High $6,025.60 | Facility | None | $851.14 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,202.26 | Professional | None | $707.95 | $851.14 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $2,344.23 | Facility | None | $2,187.76 | $2,290.87 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $426.58 Typical High $645.65 | Professional | None | $56.23 | $426.58 | $645.65 |
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 $851.14 Median $977.24 Typical High $1,230.27 | Professional | None | $851.14 | $977.24 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,096.48 | Professional | None | $851.14 | $954.99 | $1,096.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $1,479.11 | Professional | None | $630.96 | $1,071.52 | $1,479.11 |
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 $676.08 Median $812.83 Typical High $1,318.26 | Professional | None | $676.08 | $812.83 | $1,318.26 |
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 $371.54 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $588.84 |
Where Utah sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.