How much rates vary
Facilitymedian $5,129 · 10th to 90th $977 to $8,511Professionalmedian $372 · 10th to 90th $59 to $692
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 $977.24 Median $4,570.88 Typical High $8,912.51 | Facility | None | $977.24 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,122.02 | Professional | None | $660.69 | $977.24 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $6,165.95 | Facility | None | $1,862.09 | $1,995.26 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $977.24 | Professional | None | $812.83 | $831.76 | $977.24 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $346.74 Typical High $537.03 | Professional | None | $56.23 | $346.74 | $537.03 |
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 $870.96 Median $933.25 Typical High $1,023.29 | Professional | None | $870.96 | $933.25 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,165.95 | Facility | None | $5,495.41 | $5,495.41 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,348.96 | Professional | None | $741.31 | $1,148.15 | $1,348.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $2,290.87 | Professional | None | $602.56 | $1,071.52 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,265.80 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,265.80 | $8,317.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,174.90 | Professional | None | $588.84 | $691.83 | $1,174.90 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $691.83 |
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 3.6 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 $7,904MT $2,218
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.