How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,122 to $8,511Professionalmedian $457 · 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 $1,122.02 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,122.02 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | None | $812.83 | $1,122.02 | $1,122.02 |
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 $933.25 Median $954.99 Typical High $1,148.15 | Professional | None | $933.25 | $954.99 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $436.52 Typical High $645.65 | Professional | None | $56.23 | $436.52 | $645.65 |
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 $1,023.29 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,096.48 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $870.96 | $1,348.96 | $1,584.89 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $2,089.30 | Professional | None | $707.95 | $1,230.27 | $2,089.30 |
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 $691.83 Median $812.83 Typical High $1,380.38 | Professional | None | $691.83 | $812.83 | $1,380.38 |
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 $467.74 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $794.33 | $794.33 |
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 3.1 times more in Wisconsin than in Maryland. 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 $8,115MD $2,591
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.