How much rates vary
Facilitymedian $1,349 · 10th to 90th $182 to $4,169Professionalmedian $102 · 10th to 90th $76 to $214
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 $181.97 Median $3,162.28 Typical High $4,570.88 | Facility | None | $181.97 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $181.97 | Professional | None | $107.15 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $457.09 Typical High $467.74 | Facility | None | $436.52 | $457.09 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $239.88 | Professional | None | $131.83 | $154.88 | $239.88 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $102.33 | Professional | None | $74.13 | $85.11 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,089.30 | Facility | None | $1,148.15 | $1,412.54 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $257.04 | Professional | None | $177.83 | $190.55 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $87.10 Median $177.83 Typical High $288.40 | Professional | None | $87.10 | $177.83 | $288.40 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $223.87 | Professional | None | $102.33 | $131.83 | $223.87 |
5 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 $53.70 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $53.70 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $81.28 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $18.20 | $18.20 |
Where Utah sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.