How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,148 to $8,511Professionalmedian $501 · 10th to 90th $85 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 $1,148.15 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,148.15 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $478.63 Typical High $707.95 | Professional | None | $85.11 | $478.63 | $707.95 |
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 $1,096.48 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,174.90 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,737.80 | Professional | None | $912.01 | $1,479.11 | $1,737.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $724.44 Median $1,318.26 Typical High $1,995.26 | Professional | None | $724.44 | $1,318.26 | $1,995.26 |
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 $724.44 Median $851.14 Typical High $1,479.11 | Professional | None | $724.44 | $851.14 | $1,479.11 |
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 $501.19 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $812.83 |
Where Utah sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.