How much rates vary
Facilitymedian $6,026 · 10th to 90th $955 to $15,488Professionalmedian $646 · 10th to 90th $93 to $1,047
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 $9,332.54 | Facility | None | $954.99 | $3,162.28 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,258.93 | Professional | None | $660.69 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,623.41 Typical High $5,754.40 | Facility | None | $5,370.32 | $5,623.41 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,148.15 | Professional | None | $851.14 | $1,023.29 | $1,148.15 |
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 $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 $758.58 Median $1,258.93 Typical High $1,479.11 | Professional | None | $758.58 | $1,258.93 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,096.48 | Professional | None | $645.65 | $933.25 | $1,096.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $2,454.71 | Professional | None | $776.25 | $1,380.38 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $6,165.95 Typical High $8,317.64 | Facility | None | $1,288.25 | $6,165.95 | $8,317.64 |
United Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,348.96 | Professional | None | $537.03 | $851.14 | $1,348.96 |
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 $478.63 Median $478.63 Typical High $616.60 | Professional | 52 · Reduced service | $478.63 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $870.96 |
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 5.1 times more in Alaska than in West Virginia. 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 $10,217WV $2,002
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.