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 $114.82 Median $2,884.03 Typical High $4,786.30 | Facility | None | $114.82 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $173.78 | Professional | None | $109.65 | $147.91 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $128.82 Typical High $131.83 | Facility | None | $120.23 | $128.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $218.78 | Professional | None | $131.83 | $177.83 | $218.78 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | None | $95.50 | $114.82 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,445.44 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $199.53 | Professional | None | $117.49 | $169.82 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $144.54 | Professional | None | $117.49 | $125.89 | $144.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $239.88 | Professional | None | $100.00 | $181.97 | $239.88 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $229.09 | Professional | None | $102.33 | $147.91 | $229.09 |
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 $56.23 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $22.39 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $85.11 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $79.43 | $97.72 | $112.20 |
Where Utah sits
The same service costs 3.5 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· 47th of 51
$138
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.