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 $162.18 Median $208.93 Typical High $263.03 | Professional | None | $162.18 | $208.93 | $263.03 |
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 $186.21 Median $245.47 Typical High $309.03 | Professional | None | $186.21 | $245.47 | $309.03 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $234.42 | Professional | None | $151.36 | $190.55 | $234.42 |
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 $177.83 Median $239.88 Typical High $281.84 | Professional | None | $177.83 | $239.88 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $218.78 | Professional | None | $177.83 | $194.98 | $218.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $371.54 | Professional | None | $147.91 | $263.03 | $371.54 |
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 $151.36 Median $208.93 Typical High $316.23 | Professional | None | $151.36 | $208.93 | $316.23 |
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 $97.72 Typical High $112.20 | Professional | 52 · Reduced service | $83.18 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $123.03 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $114.82 | $138.04 | $158.49 |
Where Utah sits
The same service costs 4.6 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· 46th of 51
$209
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.