How much rates vary
Facilitymedian $4,169 · 10th to 90th $550 to $8,511Professionalmedian $380 · 10th to 90th $63 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 $549.54 Median $3,162.28 Typical High $8,511.38 | Facility | None | $549.54 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $776.25 | Professional | None | $426.58 | $549.54 | $776.25 |
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 $478.63 Median $630.96 Typical High $676.08 | Professional | None | $478.63 | $630.96 | $676.08 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $331.13 Typical High $489.78 | Professional | None | $56.23 | $331.13 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $831.76 | Professional | None | $512.86 | $707.95 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $741.31 | Professional | None | $436.52 | $630.96 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,230.27 | Professional | None | $478.63 | $741.31 | $1,230.27 |
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 $363.08 Median $524.81 Typical High $812.83 | Professional | None | $363.08 | $524.81 | $812.83 |
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 $275.42 Median $275.42 Typical High $389.05 | Professional | 52 · Reduced service | $275.42 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | 53 · Discontinued | $112.20 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 54 · Surgery only | $416.87 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $114.82 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $537.03 |
Where Utah sits
The same service costs 5.8 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 $8,423MT $1,458
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.