How much rates vary
Facilitymedian $4,677 · 10th to 90th $741 to $8,511Professionalmedian $355 · 10th to 90th $55 to $631
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 $741.31 Median $4,570.88 Typical High $8,912.51 | Facility | None | $741.31 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | None | $524.81 | $741.31 | $741.31 |
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 $616.60 Median $630.96 Typical High $758.58 | Professional | None | $616.60 | $630.96 | $758.58 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $309.03 Typical High $478.63 | Professional | None | $53.70 | $309.03 | $478.63 |
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 $660.69 Median $707.95 Typical High $794.33 | Professional | None | $660.69 | $707.95 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,047.13 | Professional | None | $562.34 | $912.01 | $1,047.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $1,819.70 | Professional | None | $467.74 | $831.76 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | None | $457.09 | $537.03 | $912.01 |
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 $302.00 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $524.81 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.