How much rates vary
Facilitymedian $3,981 · 10th to 90th $575 to $13,804Professionalmedian $2,951 · 10th to 90th $372 to $4,677
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 $3,162.28 Median $3,981.07 Typical High $6,025.60 | Facility | None | $3,162.28 | $3,981.07 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,981.07 | $3,981.07 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $2,818.38 Typical High $4,073.80 | Professional | None | $363.08 | $2,818.38 | $4,073.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,025.60 Median $7,079.46 Typical High $12,302.69 | Professional | None | $6,025.60 | $7,079.46 | $12,302.69 |
Select Health Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
Select Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $9,772.37 | Professional | None | $5,754.40 | $7,413.10 | $9,772.37 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $5,128.61 Typical High $10,232.93 | Professional | None | $3,890.45 | $5,128.61 | $10,232.93 |
6 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 $1,995.26 Median $1,995.26 Typical High $2,570.40 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $3,630.78 |
Where Utah sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.