How much rates vary
Facilitymedian $4,365 · 10th to 90th $692 to $15,488Professionalmedian $316 · 10th to 90th $55 to $603
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 $691.83 Median $3,388.44 Typical High $6,025.60 | Facility | None | $691.83 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | None | $467.74 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $707.95 | Professional | None | $575.44 | $588.84 | $707.95 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $281.84 Typical High $416.87 | Professional | None | $53.70 | $281.84 | $416.87 |
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 $602.56 Median $630.96 Typical High $707.95 | Professional | None | $602.56 | $630.96 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $870.96 | Professional | None | $512.86 | $741.31 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $1,513.56 | Professional | None | $436.52 | $776.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $851.14 | Professional | None | $416.87 | $489.78 | $851.14 |
6 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 $269.15 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $407.38 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $478.63 |
Where Utah sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.