How much rates vary
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 $95.50 Median $2,951.21 Typical High $4,570.88 | Facility | None | $95.50 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $147.91 | Professional | None | $95.50 | $112.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $102.33 | Facility | None | $97.72 | $100.00 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | None | $109.65 | $128.82 | $173.78 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $131.83 | Professional | None | $75.86 | $97.72 | $131.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $169.82 | Professional | None | $114.82 | $134.90 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $144.54 | Professional | None | $112.20 | $128.82 | $144.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $194.98 | Professional | None | $87.10 | $151.36 | $194.98 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $173.78 | Professional | None | $91.20 | $117.49 | $173.78 |
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 $47.86 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $47.86 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $19.50 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $72.44 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.55 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $77.62 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $67.61 | $77.62 | $87.10 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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.
Utah· 44th of 51
$115
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.