How much rates vary
Facilitymedian $5,370 · 10th to 90th $955 to $15,849Professionalmedian $372 · 10th to 90th $59 to $646
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 $954.99 Median $3,162.28 Typical High $6,025.60 | Facility | None | $954.99 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
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 $776.25 Median $831.76 Typical High $954.99 | Professional | None | $776.25 | $831.76 | $954.99 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $512.86 | Professional | None | $56.23 | $363.08 | $512.86 |
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 $812.83 Median $870.96 Typical High $954.99 | Professional | None | $812.83 | $870.96 | $954.99 |
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 $1,071.52 Typical High $1,258.93 | Professional | None | $691.83 | $1,071.52 | $1,258.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,621.81 | Professional | None | $575.44 | $1,047.13 | $1,621.81 |
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 $562.34 Median $676.08 Typical High $1,148.15 | Professional | None | $562.34 | $676.08 | $1,148.15 |
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 $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $371.54 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $676.08 |
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 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.