How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,585 to $13,804Professionalmedian $912 · 10th to 90th $63 to $1,622
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 $1,584.89 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,584.89 | $1,949.84 |
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 $1,584.89 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,659.59 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $831.76 Typical High $1,174.90 | Professional | None | $56.23 | $831.76 | $1,174.90 |
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 $1,737.80 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,089.30 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $977.24 Median $2,041.74 Typical High $4,786.30 | Professional | None | $977.24 | $2,041.74 | $4,786.30 |
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 $1,288.25 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,548.82 | $2,818.38 |
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 $724.44 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $724.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,096.48 |
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 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.