How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,995 to $15,849Professionalmedian $794 · 10th to 90th $87 to $1,413
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 $1,995.26 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,995.26 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,621.81 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $776.25 Typical High $1,148.15 | Professional | None | $85.11 | $776.25 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $18,620.87 | Facility | None | $10,232.93 | $12,882.50 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,905.46 | $1,995.26 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,454.71 | $2,884.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,230.27 | $2,398.83 | $3,630.78 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,479.11 | $2,630.27 |
7 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 $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $851.14 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,288.25 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $1,412.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $15,488.17 Median $19,498.45 Typical High $28,183.83 | Facility | 50 · Both sides | $15,488.17 | $19,498.45 | $28,183.83 |
Where Utah sits
The same service costs 5.5 times more in Alaska than in Kentucky. 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 $15,938KY $2,890
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.