How much rates vary
Facilitymedian $1,698 · 10th to 90th $138 to $4,571Professionalmedian $389 · 10th to 90th $126 to $617
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 $138.04 Median $2,951.21 Typical High $4,570.88 | Facility | None | $138.04 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $309.03 Typical High $524.81 | Professional | None | $120.23 | $309.03 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $602.56 Typical High $616.60 | Facility | None | $562.34 | $602.56 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $354.81 Typical High $549.54 | Professional | None | $134.90 | $354.81 | $549.54 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | None | $331.13 | $398.11 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,818.38 | Facility | None | $1,479.11 | $1,949.84 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $691.83 | Professional | None | $117.49 | $218.78 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $812.83 | Professional | None | $100.00 | $158.49 | $812.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $117.49 Median $575.44 Typical High $870.96 | Professional | None | $117.49 | $575.44 | $870.96 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $95.50 Median $371.54 Typical High $660.69 | Professional | None | $95.50 | $371.54 | $660.69 |
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 $67.61 Median $141.25 Typical High $263.03 | Professional | 52 · Reduced service | $67.61 | $141.25 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $56.23 Typical High $104.71 | Professional | 53 · Discontinued | $26.92 | $56.23 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $213.80 Typical High $389.05 | Professional | 54 · Surgery only | $100.00 | $213.80 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $42.66 Typical High $77.62 | Professional | 55 · Aftercare only | $19.95 | $42.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $28.18 Typical High $52.48 | Professional | 56 · Pre-op care only | $13.49 | $28.18 | $52.48 |
Where Utah sits
The same service costs 4.5 times more in New York than in Alabama. 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
NY $3,101AL $693
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.