How much rates vary
Facilitymedian $4,169 · 10th to 90th $851 to $10,965Professionalmedian $427 · 10th to 90th $316 to $851
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 $851.14 Median $3,388.44 Typical High $6,025.60 | Facility | None | $851.14 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $851.14 | Professional | None | $630.96 | $851.14 | $851.14 |
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 $707.95 Median $794.33 Typical High $1,148.15 | Professional | None | $707.95 | $794.33 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $524.81 | Professional | None | $302.00 | $398.11 | $524.81 |
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 $758.58 Median $912.01 Typical High $1,148.15 | Professional | None | $758.58 | $912.01 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $426.58 Median $933.25 Typical High $1,445.44 | Professional | None | $426.58 | $933.25 | $1,445.44 |
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 $562.34 Median $691.83 Typical High $1,258.93 | Professional | None | $562.34 | $691.83 | $1,258.93 |
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 $309.03 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $125.89 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $467.74 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $436.52 | $602.56 | $602.56 |
Where Utah sits
The same service costs 5.7 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 $10,813MT $1,910
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.