How much rates vary
Facilitymedian $3,311 · 10th to 90th $708 to $7,079Professionalmedian $661 · 10th to 90th $98 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 $707.95 Median $3,162.28 Typical High $8,511.38 | Facility | None | $707.95 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,000.00 | Professional | None | $691.83 | $776.25 | $1,000.00 |
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 $794.33 Median $954.99 Typical High $1,174.90 | Professional | None | $794.33 | $954.99 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $501.19 Typical High $776.25 | Professional | None | $85.11 | $501.19 | $776.25 |
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 $724.44 Median $891.25 Typical High $1,047.13 | Professional | None | $724.44 | $891.25 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $870.96 | Professional | None | $707.95 | $776.25 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,995.26 | Professional | None | $691.83 | $1,096.48 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,202.26 | Professional | None | $630.96 | $812.83 | $1,202.26 |
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 $346.74 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $588.84 |
Where Utah sits
The same service costs 3.1 times more in Alaska than in Maryland. 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 $5,990MD $1,938
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.