How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,288 to $10,233Professionalmedian $513 · 10th to 90th $59 to $912
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 $1,288.25 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,288.25 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,288.25 | $1,288.25 |
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 $1,122.02 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,122.02 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $489.78 Typical High $724.44 | Professional | None | $56.23 | $489.78 | $724.44 |
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 $1,202.26 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,288.25 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,584.89 | $1,862.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,187.76 | Professional | None | $831.76 | $1,380.38 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,659.59 | Professional | None | $851.14 | $954.99 | $1,659.59 |
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 $549.54 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $912.01 |
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 16.2 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
$513
AK $3,890TX $240
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.