How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,445 to $13,804Professionalmedian $832 · 10th to 90th $63 to $1,445
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 $4,570.88 Typical High $12,022.64 | Facility | None | $1,445.44 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,445.44 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,513.56 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $758.58 Typical High $1,071.52 | Professional | None | $56.23 | $758.58 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,332.54 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,905.46 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $891.25 Median $1,862.09 Typical High $4,168.69 | Professional | None | $891.25 | $1,862.09 | $4,168.69 |
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 $1,174.90 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,412.54 | $2,570.40 |
7 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 $645.65 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,023.29 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,197.01 Typical High $26,302.68 | Facility | 50 · Both sides | $13,803.84 | $18,197.01 | $26,302.68 |
Where Utah sits
The same service costs 6.2 times more in Alaska than in Utah. 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.
Utah· 51st of 51
$851
AK $5,248UT $851
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.