How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,479 to $16,982Professionalmedian $603 · 10th to 90th $59 to $1,072
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 $1,479.11 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,479.11 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,370.32 | $5,495.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,230.27 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $562.34 Typical High $870.96 | Professional | None | $56.23 | $562.34 | $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 $1,412.54 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,479.11 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,819.70 | $2,137.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,778.28 Typical High $3,467.37 | Professional | None | $977.24 | $1,778.28 | $3,467.37 |
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 $870.96 Median $1,071.52 Typical High $1,862.09 | Professional | None | $870.96 | $1,071.52 | $1,862.09 |
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 $630.96 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $1,023.29 | $1,023.29 |
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 13.8 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
$603
AK $4,467TX $324
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.