How much rates vary
Facilitymedian $4,677 · 10th to 90th $776 to $8,511Professionalmedian $295 · 10th to 90th $59 to $537
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 $776.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $776.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | None | $537.03 | $776.25 | $776.25 |
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 $660.69 Median $676.08 Typical High $794.33 | Professional | None | $660.69 | $676.08 | $794.33 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $281.84 Typical High $426.58 | Professional | None | $56.23 | $281.84 | $426.58 |
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 $676.08 Median $724.44 Typical High $794.33 | Professional | None | $676.08 | $724.44 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,047.13 | Professional | None | $575.44 | $891.25 | $1,047.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $1,380.38 | Professional | None | $489.78 | $870.96 | $1,380.38 |
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 $467.74 Median $549.54 Typical High $977.24 | Professional | None | $467.74 | $549.54 | $977.24 |
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 $302.00 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $302.00 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $549.54 | $549.54 |
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 4.3 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 $7,406MT $1,722
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.