How much rates vary
Facilitymedian $4,169 · 10th to 90th $851 to $8,318Professionalmedian $692 · 10th to 90th $87 to $1,122
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 $851.14 Median $3,388.44 Typical High $6,025.60 | Facility | None | $851.14 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,737.80 | Professional | None | $724.44 | $724.44 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $676.08 Typical High $954.99 | Professional | None | $85.11 | $676.08 | $954.99 |
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 $1,584.89 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,698.24 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,348.96 | $2,041.74 | $2,398.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,096.48 | $1,949.84 | $2,818.38 |
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 $524.81 Median $1,174.90 Typical High $2,137.96 | Professional | None | $524.81 | $1,174.90 | $2,137.96 |
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 $426.58 Median $426.58 Typical High $575.44 | Professional | 52 · Reduced service | $426.58 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $229.09 | Professional | 53 · Discontinued | $169.82 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $114.82 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $812.83 |
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 3.7 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 $9,494KY $2,537
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.