How much rates vary
Facilitymedian $5,129 · 10th to 90th $631 to $9,120Professionalmedian $331 · 10th to 90th $245 to $631
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 $9,120.11 | Facility | None | $630.96 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $891.25 | Professional | None | $457.09 | $630.96 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $812.83 | Professional | None | $501.19 | $616.60 | $812.83 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $389.05 | Professional | None | $229.09 | $309.03 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $10,471.29 | Facility | None | $5,754.40 | $7,244.36 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $741.31 | Professional | None | $549.54 | $645.65 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $1,479.11 | Professional | None | $323.59 | $645.65 | $1,479.11 |
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 $398.11 Median $537.03 Typical High $912.01 | Professional | None | $398.11 | $537.03 | $912.01 |
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 $223.87 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $316.23 | $446.68 | $446.68 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $10,964.78 Typical High $15,848.93 | Facility | 50 · Both sides | $8,709.64 | $10,964.78 | $15,848.93 |
Where Utah sits
The same service costs 5.5 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 $1,352
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.