How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,585 to $15,849Professionalmedian $603 · 10th to 90th $87 to $1,096
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 $1,584.89 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,584.89 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,370.32 | $5,495.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,348.96 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $575.44 Typical High $870.96 | Professional | None | $85.11 | $575.44 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $18,620.87 | Facility | None | $10,232.93 | $12,882.50 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,513.56 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,862.09 | $2,187.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,737.80 Typical High $3,715.35 | Professional | None | $977.24 | $1,737.80 | $3,715.35 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,905.46 | Professional | None | $912.01 | $1,122.02 | $1,905.46 |
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 $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $1,096.48 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $15,488.17 Median $19,498.45 Typical High $28,183.83 | Facility | 50 · Both sides | $15,488.17 | $19,498.45 | $28,183.83 |
Where Utah sits
The same service costs 8.7 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
$617
AK $4,571TX $525
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.