How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,318 to $11,220Professionalmedian $646 · 10th to 90th $56 to $1,230
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 $1,318.26 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,318.26 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | None | $954.99 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,235.94 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,230.27 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $602.56 Typical High $776.25 | Professional | None | $54.95 | $602.56 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,471.29 Typical High $15,135.61 | Facility | None | $7,943.28 | $10,471.29 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,348.96 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $2,344.23 | Professional | None | $645.65 | $1,380.38 | $2,344.23 |
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 $851.14 Median $1,071.52 Typical High $1,949.84 | Professional | None | $851.14 | $1,071.52 | $1,949.84 |
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 $478.63 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $478.63 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $707.95 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $95.50 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $660.69 | $933.25 | $933.25 |
Where Utah sits
The same service costs 4.1 times more in Alaska 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
AK $9,881DE $2,434
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.