How much rates vary
Facilitymedian $2,951 · 10th to 90th $275 to $13,804Professionalmedian $234 · 10th to 90th $174 to $447
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 $275.42 Median $3,162.28 Typical High $6,025.60 | Facility | None | $275.42 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | None | $245.47 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $575.44 | Professional | None | $309.03 | $338.84 | $575.44 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | None | $169.82 | $194.98 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $724.44 | Professional | None | $331.13 | $389.05 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $234.42 Median $407.38 Typical High $831.76 | Professional | None | $234.42 | $407.38 | $831.76 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $562.34 | Professional | None | $245.47 | $288.40 | $562.34 |
5 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 $123.03 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $27.54 | $27.54 |
Where Utah sits
The same service costs 32.0 times more in Maine 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
ME $26,674MT $834
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.