How much rates vary
Facilitymedian $490 · 10th to 90th $120 to $4,467Professionalmedian $107 · 10th to 90th $79 to $162
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 $120.23 Median $2,951.21 Typical High $4,570.88 | Facility | None | $120.23 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $151.36 | Professional | None | $93.33 | $120.23 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $117.49 Typical High $120.23 | Facility | None | $112.20 | $117.49 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $147.91 | Professional | None | $104.71 | $128.82 | $147.91 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $128.82 | Professional | None | $75.86 | $97.72 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Facility | None | $371.54 | $489.78 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $190.55 | Professional | None | $120.23 | $162.18 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $208.93 | Professional | None | $102.33 | $177.83 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $288.40 | Professional | None | $100.00 | $169.82 | $288.40 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $173.78 | Professional | None | $81.28 | $107.15 | $173.78 |
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 $60.26 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $107.15 |
Where Utah sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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
HI $2,944MD $224
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.