How much rates vary
Facilitymedian $5,129 · 10th to 90th $229 to $32,359Professionalmedian $3,311 · 10th to 90th $347 to $4,571
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 $229.09 Median $2,951.21 Typical High $4,570.88 | Facility | None | $229.09 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $380.19 | Professional | None | $229.09 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $9,772.37 Median $10,232.93 Typical High $10,471.29 | Facility | None | $9,772.37 | $10,232.93 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $630.96 | Professional | None | $199.53 | $251.19 | $630.96 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $3,388.44 Typical High $4,466.84 | Professional | None | $398.11 | $3,388.44 | $4,466.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $20,417.38 Median $26,302.68 Typical High $37,153.52 | Facility | None | $20,417.38 | $26,302.68 | $37,153.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $6,918.31 | Professional | None | $724.44 | $1,000.00 | $6,918.31 |
Select Health Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $758.58 | Professional | None | $478.63 | $645.65 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $354.81 Median $4,265.80 Typical High $9,332.54 | Professional | None | $354.81 | $4,265.80 | $9,332.54 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $9,120.11 Typical High $74,131.02 | Facility | None | $2,398.83 | $9,120.11 | $74,131.02 |
United Setting Professional Modifier None Typical Low $158.49 Median $363.08 Typical High $3,388.44 | Professional | None | $158.49 | $363.08 | $3,388.44 |
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 $112.20 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $112.20 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $45.71 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $218.78 Typical High $281.84 | Professional | 54 · Surgery only | $169.82 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $43.65 Typical High $56.23 | Professional | 55 · Aftercare only | $33.88 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.91 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $204.17 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $158.49 | $204.17 | $263.03 |
Where Utah sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.