How much rates vary
Facilitymedian $6,457 · 10th to 90th $891 to $15,488Professionalmedian $372 · 10th to 90th $59 to $631
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 $891.25 Median $4,570.88 Typical High $9,120.11 | Facility | None | $891.25 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $891.25 | Professional | None | $630.96 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $6,309.57 Median $6,456.54 Typical High $6,606.93 | Facility | None | $6,309.57 | $6,456.54 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $933.25 | Professional | None | $758.58 | $776.25 | $933.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $346.74 Typical High $501.19 | Professional | None | $56.23 | $346.74 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $977.24 | Professional | None | $831.76 | $870.96 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,288.25 | Professional | None | $691.83 | $1,096.48 | $1,288.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $2,884.03 | Professional | None | $562.34 | $1,000.00 | $2,884.03 |
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 $549.54 Median $645.65 Typical High $1,122.02 | Professional | None | $549.54 | $645.65 | $1,122.02 |
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 $371.54 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $630.96 | $630.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 5.4 times more in Alaska 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
AK $11,142MT $2,070
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.