How much rates vary
Facilitymedian $5,129 · 10th to 90th $759 to $9,120Professionalmedian $437 · 10th to 90th $55 to $708
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 $758.58 Median $4,570.88 Typical High $9,120.11 | Facility | None | $758.58 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $776.25 | Professional | None | $602.56 | $758.58 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $977.24 | Professional | None | $691.83 | $707.95 | $977.24 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $416.87 Typical High $537.03 | Professional | None | $54.95 | $416.87 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $10,471.29 | Facility | None | $5,754.40 | $7,244.36 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,000.00 | Professional | None | $758.58 | $870.96 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,174.90 | Professional | None | $630.96 | $1,000.00 | $1,174.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $457.09 Median $831.76 Typical High $1,513.56 | Professional | None | $457.09 | $831.76 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,071.52 | Professional | None | $524.81 | $602.56 | $1,071.52 |
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 $302.00 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $537.03 | $537.03 |
Where Utah sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.