How much rates vary
Facilitymedian $10,233 · 10th to 90th $871 to $27,542Professionalmedian $339 · 10th to 90th $59 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 $870.96 Median $4,570.88 Typical High $9,120.11 | Facility | None | $870.96 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $10,964.78 Median $11,220.18 Typical High $11,481.54 | Facility | None | $10,964.78 | $11,220.18 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $891.25 | Professional | None | $724.44 | $758.58 | $891.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $323.59 Typical High $478.63 | Professional | None | $56.23 | $323.59 | $478.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $21,379.62 Median $26,302.68 Typical High $38,904.51 | Facility | None | $21,379.62 | $26,302.68 | $38,904.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $912.01 | Professional | None | $776.25 | $831.76 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,202.26 | Professional | None | $660.69 | $1,047.13 | $1,202.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,737.80 | Professional | None | $562.34 | $1,000.00 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $13,489.63 Typical High $15,848.93 | Facility | None | $2,398.83 | $13,489.63 | $15,848.93 |
United Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $1,071.52 | Professional | None | $524.81 | $616.60 | $1,071.52 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $616.60 | $616.60 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $31,622.78 Median $39,810.72 Typical High $57,543.99 | Facility | 50 · Both sides | $31,622.78 | $39,810.72 | $57,543.99 |
Where Utah sits
The same service costs 10.1 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 $19,890MT $1,977
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.