How much rates vary
Facilitymedian $4,571 · 10th to 90th $661 to $8,511Professionalmedian $302 · 10th to 90th $56 to $562
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 $660.69 Median $4,570.88 Typical High $8,912.51 | Facility | None | $660.69 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None | $489.78 | $660.69 | $660.69 |
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 $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $288.40 Typical High $398.11 | Professional | None | $54.95 | $288.40 | $398.11 |
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 $602.56 Median $645.65 Typical High $707.95 | Professional | None | $602.56 | $645.65 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $933.25 | Professional | None | $512.86 | $794.33 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $1,479.11 | Professional | None | $398.11 | $741.31 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $812.83 | Professional | None | $398.11 | $478.63 | $812.83 |
6 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 $275.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $467.74 | $467.74 |
Where Utah sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.