How much rates vary
Facilitymedian $4,169 · 10th to 90th $525 to $10,233Professionalmedian $1,259 · 10th to 90th $398 to $2,344
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 $524.81 Median $3,162.28 Typical High $8,511.38 | Facility | None | $524.81 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,202.26 Typical High $1,819.70 | Professional | None | $436.52 | $1,202.26 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,862.09 | $1,905.46 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,318.26 Typical High $2,187.76 | Professional | None | $446.68 | $1,318.26 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $1,230.27 Typical High $1,778.28 | Professional | None | $147.91 | $1,230.27 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $6,456.54 Typical High $9,332.54 | Facility | None | $5,248.07 | $6,456.54 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $1,479.11 Typical High $2,290.87 | Professional | None | $512.86 | $1,479.11 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $257.04 Median $1,513.56 Typical High $3,630.78 | Professional | None | $257.04 | $1,513.56 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $11,481.54 | Facility | None | $1,288.25 | $4,168.69 | $11,481.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $1,148.15 Typical High $2,570.40 | Professional | None | $389.05 | $1,148.15 | $2,570.40 |
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 $263.03 Median $575.44 Typical High $891.25 | Professional | 52 · Reduced service | $263.03 | $575.44 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $229.09 Typical High $363.08 | Professional | 53 · Discontinued | $104.71 | $229.09 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $851.14 Typical High $1,348.96 | Professional | 54 · Surgery only | $398.11 | $851.14 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $169.82 Typical High $269.15 | Professional | 55 · Aftercare only | $79.43 | $169.82 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $114.82 Typical High $181.97 | Professional | 56 · Pre-op care only | $52.48 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $794.33 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $371.54 | $794.33 | $1,258.93 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $9,772.37 Typical High $14,125.38 | Facility | 50 · Both sides | $7,762.47 | $9,772.37 | $14,125.38 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 18th of 51
$1,514
AK $3,020NE $692
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.