How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,549 to $8,511Professionalmedian $562 · 10th to 90th $87 to $977
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 $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,548.82 | $1,548.82 |
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 $1,174.90 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,318.26 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $537.03 Typical High $794.33 | Professional | None | $85.11 | $537.03 | $794.33 |
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 $1,258.93 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,318.26 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,659.59 | $1,949.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $2,290.87 | Professional | None | $870.96 | $1,513.56 | $2,290.87 |
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 $831.76 Median $1,047.13 Typical High $1,737.80 | Professional | None | $831.76 | $1,047.13 | $1,737.80 |
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 $575.44 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $1,071.52 | $1,071.52 |
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 7.6 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
$562
AK $3,981TX $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.