How much rates vary
Facilitymedian $5,370 · 10th to 90th $724 to $15,136Professionalmedian $407 · 10th to 90th $56 to $661
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 $724.44 Median $4,570.88 Typical High $12,022.64 | Facility | None | $724.44 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,023.29 | Professional | None | $537.03 | $724.44 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $933.25 | Professional | None | $660.69 | $660.69 | $933.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $398.11 Typical High $512.86 | Professional | None | $54.95 | $398.11 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $12,022.64 Typical High $17,378.01 | Facility | None | $9,120.11 | $12,022.64 | $17,378.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $954.99 | Professional | None | $724.44 | $812.83 | $954.99 |
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 $602.56 Median $1,000.00 Typical High $1,174.90 | Professional | None | $602.56 | $1,000.00 | $1,174.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $436.52 Median $812.83 Typical High $1,949.84 | Professional | None | $436.52 | $812.83 | $1,949.84 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,023.29 | Professional | None | $501.19 | $575.44 | $1,023.29 |
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 $288.40 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $398.11 | $501.19 | $501.19 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,197.01 Typical High $26,302.68 | Facility | 50 · Both sides | $13,803.84 | $18,197.01 | $26,302.68 |
Where Utah sits
The same service costs 6.0 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 $11,096MT $1,846
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.