How much rates vary
Facilitymedian $9,333 · 10th to 90th $427 to $63,096Professionalmedian $219 · 10th to 90th $55 to $389
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 $426.58 Median $3,162.28 Typical High $4,570.88 | Facility | None | $426.58 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | None | $371.54 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $15,488.17 Median $16,218.10 Typical High $16,218.10 | Facility | None | $15,488.17 | $16,218.10 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | None | $371.54 | $371.54 | $436.52 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $199.53 Typical High $288.40 | Professional | None | $53.70 | $199.53 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $35,481.34 Median $44,668.36 Typical High $64,565.42 | Facility | None | $35,481.34 | $44,668.36 | $64,565.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $588.84 | Professional | None | $501.19 | $537.03 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $524.81 | Professional | None | $338.84 | $446.68 | $524.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $275.42 Median $524.81 Typical High $1,174.90 | Professional | None | $275.42 | $524.81 | $1,174.90 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $11,481.54 Typical High $74,131.02 | Facility | None | $2,691.53 | $11,481.54 | $74,131.02 |
United Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $537.03 | Professional | None | $263.03 | $316.23 | $537.03 |
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 $181.97 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $302.00 | $302.00 |
Where Utah sits
The same service costs 29.1 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 $30,626MT $1,051
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.