How much rates vary
Facilitymedian $2,884 · 10th to 90th $229 to $4,786Professionalmedian $309 · 10th to 90th $229 to $437
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 $229.09 Median $2,884.03 Typical High $4,786.30 | Facility | None | $229.09 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $354.81 | Professional | None | $218.78 | $295.12 | $354.81 |
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 $295.12 Median $398.11 Typical High $457.09 | Professional | None | $295.12 | $398.11 | $457.09 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $371.54 | Professional | None | $263.03 | $309.03 | $371.54 |
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 $234.42 Median $363.08 Typical High $426.58 | Professional | None | $234.42 | $363.08 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | None | $234.42 | $257.04 | $288.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $645.65 | Professional | None | $239.88 | $407.38 | $645.65 |
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 $213.80 Median $316.23 Typical High $467.74 | Professional | None | $213.80 | $316.23 | $467.74 |
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 $112.20 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $112.20 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $44.67 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $169.82 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $33.88 |
Where Utah sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.