How much rates vary
Facilitymedian $4,571 · 10th to 90th $646 to $8,511Professionalmedian $389 · 10th to 90th $56 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 $645.65 Median $4,570.88 Typical High $9,772.37 | Facility | None | $645.65 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,023.29 | Professional | None | $512.86 | $645.65 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,096.48 | Professional | None | $616.60 | $676.08 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $363.08 Typical High $512.86 | Professional | None | $54.95 | $363.08 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $9,549.93 | Facility | None | $4,786.30 | $6,606.93 | $9,549.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $977.24 | Professional | None | $741.31 | $870.96 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $398.11 Median $851.14 Typical High $1,513.56 | Professional | None | $398.11 | $851.14 | $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 $501.19 Median $602.56 Typical High $1,148.15 | Professional | None | $501.19 | $602.56 | $1,148.15 |
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 $275.42 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $457.09 |
Where Utah sits
The same service costs 3.6 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 $6,446MT $1,806
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.