How much rates vary
Facilitymedian $9,120 · 10th to 90th $661 to $21,878Professionalmedian $4,169 · 10th to 90th $457 to $6,761
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 $660.69 Median $6,025.60 Typical High $10,232.93 | Facility | None | $660.69 | $6,025.60 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $4,570.88 Typical High $9,549.93 | Professional | None | $630.96 | $4,570.88 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $9,120.11 Typical High $9,120.11 | Facility | None | $8,709.64 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $5,495.41 Typical High $9,772.37 | Professional | None | $645.65 | $5,495.41 | $9,772.37 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $4,168.69 Typical High $5,495.41 | Professional | None | $457.09 | $4,168.69 | $5,495.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,848.93 Median $21,379.62 Typical High $27,542.29 | Facility | None | $15,848.93 | $21,379.62 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $8,317.64 | Professional | None | $562.34 | $1,047.13 | $8,317.64 |
Select Health Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $10,000.00 | Professional | None | $478.63 | $758.58 | $10,000.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $549.54 Median $6,918.31 Typical High $12,022.64 | Professional | None | $549.54 | $6,918.31 | $12,022.64 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $446.68 Median $5,623.41 Typical High $10,000.00 | Professional | None | $446.68 | $5,623.41 | $10,000.00 |
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 $316.23 Median $660.69 Typical High $4,786.30 | Professional | 52 · Reduced service | $316.23 | $660.69 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $263.03 Typical High $1,949.84 | Professional | 53 · Discontinued | $125.89 | $263.03 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $977.24 Typical High $7,244.36 | Professional | 54 · Surgery only | $478.63 | $977.24 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $199.53 Typical High $1,445.44 | Professional | 55 · Aftercare only | $95.50 | $199.53 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $131.83 Typical High $954.99 | Professional | 56 · Pre-op care only | $63.10 | $131.83 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $912.01 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $446.68 | $912.01 | $6,760.83 |
Where Utah sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.