How much rates vary
Facilitymedian $4,169 · 10th to 90th $851 to $8,318Professionalmedian $324 · 10th to 90th $59 to $550
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 $588.84 Median $851.14 Typical High $851.14 | Professional | None | $588.84 | $851.14 | $851.14 |
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 $741.31 Typical High $870.96 | Professional | None | $724.44 | $741.31 | $870.96 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $309.03 Typical High $436.52 | Professional | None | $56.23 | $309.03 | $436.52 |
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 $758.58 Median $794.33 Typical High $891.25 | Professional | None | $758.58 | $794.33 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,148.15 | Professional | None | $630.96 | $977.24 | $1,148.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $512.86 Median $912.01 Typical High $1,949.84 | Professional | None | $512.86 | $912.01 | $1,949.84 |
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 $602.56 Typical High $1,023.29 | Professional | None | $524.81 | $602.56 | $1,023.29 |
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 $338.84 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $501.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $467.74 | $602.56 | $602.56 |
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 4.0 times more in Oklahoma 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
OK $7,626MT $1,888
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.