How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $13,804Professionalmedian $832 · 10th to 90th $83 to $1,413
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 $1,584.89 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,584.89 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,584.89 | $1,584.89 |
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 $1,412.54 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,479.11 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $812.83 Typical High $1,047.13 | Professional | None | $83.18 | $812.83 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,737.80 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,288.25 | $2,041.74 | $2,398.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,000.00 | $1,698.24 | $3,019.95 |
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 $1,071.52 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,230.27 | $2,238.72 |
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 $616.60 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $616.60 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $245.47 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $186.21 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $123.03 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $1,096.48 | $1,096.48 |
Where Utah sits
The same service costs 5.9 times more in Alabama 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
AL $10,682MD $1,821
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.