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 $190.55 Median $2,884.03 Typical High $4,786.30 | Facility | None | $190.55 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $316.23 | Professional | None | $177.83 | $245.47 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $891.25 | Facility | None | $851.14 | $870.96 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $380.19 | Professional | None | $223.87 | $302.00 | $380.19 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $186.21 Typical High $251.19 | Professional | None | $26.92 | $186.21 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,570.40 | $3,311.31 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $331.13 | Professional | None | $194.98 | $281.84 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | None | $194.98 | $218.78 | $251.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $457.09 | Professional | None | $169.82 | $316.23 | $457.09 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $389.05 | Professional | None | $177.83 | $257.04 | $389.05 |
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 $93.33 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $37.15 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $131.83 | $165.96 | $190.55 |
Where Utah sits
The same service costs 4.2 times more in Alaska than in Utah. 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· 51st of 51
$214
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.