How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,096 to $10,965Professionalmedian $550 · 10th to 90th $56 to $1,047
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 $1,096.48 Median $3,162.28 Typical High $4,570.88 | Facility | None | $1,096.48 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | None | $794.33 | $1,096.48 | $1,096.48 |
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 $912.01 Median $1,023.29 Typical High $1,479.11 | Professional | None | $912.01 | $1,023.29 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $537.03 Typical High $707.95 | Professional | None | $54.95 | $537.03 | $707.95 |
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 $977.24 Median $1,174.90 Typical High $1,479.11 | Professional | None | $977.24 | $1,174.90 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $537.03 Median $1,202.26 Typical High $1,445.44 | Professional | None | $537.03 | $1,202.26 | $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 $724.44 Median $891.25 Typical High $1,621.81 | Professional | None | $724.44 | $891.25 | $1,621.81 |
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 $398.11 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $398.11 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $602.56 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $120.23 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $562.34 | $776.25 | $776.25 |
Where Utah sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $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.