How much rates vary
Facilitymedian $4,677 · 10th to 90th $631 to $8,511Professionalmedian $288 · 10th to 90th $56 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 $630.96 Median $4,570.88 Typical High $8,912.51 | Facility | None | $630.96 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | None | $524.81 | $630.96 | $630.96 |
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 $537.03 Median $537.03 Typical High $645.65 | Professional | None | $537.03 | $537.03 | $645.65 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $275.42 Typical High $389.05 | Professional | None | $54.95 | $275.42 | $389.05 |
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 $588.84 Median $616.60 Typical High $691.83 | Professional | None | $588.84 | $616.60 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $912.01 | Professional | None | $489.78 | $794.33 | $912.01 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $1,584.89 | Professional | None | $380.19 | $724.44 | $1,584.89 |
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 $389.05 Median $457.09 Typical High $776.25 | Professional | None | $389.05 | $457.09 | $776.25 |
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 $257.04 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $436.52 |
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 4.9 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 $7,341MT $1,483
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.