How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,445 to $13,804Professionalmedian $661 · 10th to 90th $83 to $1,259
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 $1,445.44 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,445.44 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $5,011.87 | Facility | None | $4,786.30 | $4,897.79 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,258.93 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $630.96 Typical High $831.76 | Professional | None | $83.18 | $630.96 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,471.29 Median $13,182.57 Typical High $19,054.61 | Facility | None | $10,471.29 | $13,182.57 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,659.59 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,584.89 | $1,862.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $3,019.95 | Professional | None | $870.96 | $1,548.82 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,778.28 | Professional | None | $870.96 | $1,023.29 | $1,778.28 |
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 $588.84 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $1,023.29 | $1,023.29 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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 $10,992HI $2,489
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.