How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,202 to $8,511Professionalmedian $457 · 10th to 90th $59 to $832
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 $1,202.26 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,202.26 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | None | $977.24 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,398.83 | $2,454.71 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,023.29 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $436.52 Typical High $676.08 | Professional | None | $56.23 | $436.52 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,148.15 | $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 $912.01 Median $1,412.54 Typical High $1,659.59 | Professional | None | $912.01 | $1,412.54 | $1,659.59 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $2,089.30 | Professional | None | $776.25 | $1,380.38 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,445.44 | Professional | None | $724.44 | $870.96 | $1,445.44 |
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 $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $831.76 | $831.76 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 7.9 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
$457
AK $3,467TX $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.