How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,445 to $8,511Professionalmedian $832 · 10th to 90th $115 to $1,549
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 $1,445.44 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,445.44 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,445.44 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,737.80 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,513.56 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $794.33 Typical High $1,096.48 | Professional | None | $109.65 | $794.33 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,862.09 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $891.25 Median $1,778.28 Typical High $2,511.89 | Professional | None | $891.25 | $1,778.28 | $2,511.89 |
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 $1,174.90 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,348.96 | $2,630.27 |
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 $660.69 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,000.00 |
Where Utah sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $8,931DE $2,772
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.