How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,230 to $15,849Professionalmedian $479 · 10th to 90th $59 to $871
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 $1,230.27 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,230.27 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
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 $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,023.29 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $467.74 Typical High $707.95 | Professional | None | $56.23 | $467.74 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,174.90 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,659.59 | Professional | None | $933.25 | $1,445.44 | $1,659.59 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $1,995.26 | Professional | None | $794.33 | $1,318.26 | $1,995.26 |
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 $724.44 Median $870.96 Typical High $1,479.11 | Professional | None | $724.44 | $870.96 | $1,479.11 |
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 $489.78 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $851.14 | $851.14 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 8.1 times more in Alaska than in Texas. 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· 50th of 51
$490
AK $3,548TX $437
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.