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 $165.96 Median $2,951.21 Typical High $4,570.88 | Facility | None | $165.96 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $281.84 | Professional | None | $165.96 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $158.49 | Facility | None | $147.91 | $154.88 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $302.00 | Professional | None | $194.98 | $218.78 | $302.00 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $199.53 | Professional | None | $125.89 | $162.18 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $1,202.26 | Facility | None | $630.96 | $831.76 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $295.12 | Professional | None | $194.98 | $229.09 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $251.19 | Professional | None | $194.98 | $223.87 | $251.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $354.81 | Professional | None | $151.36 | $263.03 | $354.81 |
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 $158.49 Median $204.17 Typical High $302.00 | Professional | None | $158.49 | $204.17 | $302.00 |
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 $83.18 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $125.89 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $147.91 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in Florida. 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
$195
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.