How much rates vary
Facilitymedian $4,677 · 10th to 90th $891 to $8,511Professionalmedian $339 · 10th to 90th $59 to $603
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 $891.25 Median $4,570.88 Typical High $9,120.11 | Facility | None | $891.25 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | None | $707.95 | $891.25 | $891.25 |
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 $741.31 Median $776.25 Typical High $912.01 | Professional | None | $741.31 | $776.25 | $912.01 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $323.59 Typical High $478.63 | Professional | None | $56.23 | $323.59 | $478.63 |
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 $776.25 Median $831.76 Typical High $912.01 | Professional | None | $776.25 | $831.76 | $912.01 |
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 $660.69 Median $1,000.00 Typical High $1,174.90 | Professional | None | $660.69 | $1,000.00 | $1,174.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $2,041.74 | Professional | None | $524.81 | $954.99 | $2,041.74 |
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 $537.03 Median $630.96 Typical High $1,047.13 | Professional | None | $537.03 | $630.96 | $1,047.13 |
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 $354.81 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $616.60 | $616.60 |
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 4.0 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 $7,647MT $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.