How much rates vary
Facilitymedian $4,677 · 10th to 90th $813 to $8,511Professionalmedian $339 · 10th to 90th $59 to $575
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 $812.83 Median $4,570.88 Typical High $9,772.37 | Facility | None | $812.83 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $933.25 | Professional | None | $575.44 | $812.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | None | $691.83 | $691.83 | $831.76 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $323.59 Typical High $457.09 | Professional | None | $56.23 | $323.59 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $891.25 | Professional | None | $758.58 | $794.33 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,174.90 | Professional | None | $630.96 | $1,000.00 | $1,174.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,548.82 | Professional | None | $489.78 | $912.01 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,000.00 | Professional | None | $501.19 | $588.84 | $1,000.00 |
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 $338.84 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $562.34 | $562.34 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 3.9 times more in Wisconsin 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
WI $7,471MT $1,932
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.