How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,023 to $7,586Professionalmedian $501 · 10th to 90th $56 to $891
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 $1,023.29 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,023.29 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | None | $724.44 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,148.15 | Facility | None | $1,071.52 | $1,122.02 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,047.13 | Professional | None | $870.96 | $891.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $478.63 Typical High $630.96 | Professional | None | $54.95 | $478.63 | $630.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,162.28 | $3,981.07 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,230.27 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,412.54 | Professional | None | $776.25 | $1,202.26 | $1,412.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $1,778.28 | Professional | None | $630.96 | $1,174.90 | $1,778.28 |
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 $616.60 Median $741.31 Typical High $1,258.93 | Professional | None | $616.60 | $741.31 | $1,258.93 |
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 $426.58 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $724.44 | $724.44 |
Where Utah sits
The same service costs 3.0 times more in Alaska than in Maryland. 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
AK $5,643MD $1,856
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.