How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,023 to $8,511Professionalmedian $490 · 10th to 90th $59 to $813
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 $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
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 $870.96 Median $870.96 Typical High $1,071.52 | Professional | None | $870.96 | $870.96 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $446.68 Typical High $676.08 | Professional | None | $56.23 | $446.68 | $676.08 |
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 $1,000.00 Median $1,071.52 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,071.52 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,621.81 | Professional | None | $831.76 | $1,380.38 | $1,621.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $2,511.89 | Professional | None | $676.08 | $1,258.93 | $2,511.89 |
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 $645.65 Median $776.25 Typical High $1,318.26 | Professional | None | $645.65 | $776.25 | $1,318.26 |
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 $457.09 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $724.44 | $724.44 |
Where Utah sits
The same service costs 3.1 times more in Wisconsin 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
WI $7,619HI $2,493
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.