How much rates vary
Facilitymedian $4,571 · 10th to 90th $933 to $11,482Professionalmedian $468 · 10th to 90th $50 to $871
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 $933.25 Median $4,570.88 Typical High $12,022.64 | Facility | None | $933.25 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | None | $691.83 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $2,754.23 | Facility | None | $2,630.27 | $2,691.53 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,288.25 | Professional | None | $794.33 | $851.14 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $436.52 Typical High $588.84 | Professional | None | $48.98 | $436.52 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,244.36 Median $9,120.11 Typical High $13,182.57 | Facility | None | $7,244.36 | $9,120.11 | $13,182.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | None | $870.96 | $1,023.29 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $467.74 Median $1,047.13 Typical High $1,513.56 | Professional | None | $467.74 | $1,047.13 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,412.54 | Professional | None | $645.65 | $758.58 | $1,412.54 |
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 $354.81 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $144.54 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $645.65 | $645.65 |
Where Utah sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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
AK $8,442KY $1,804
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.