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 $162.18 Median $2,951.21 Typical High $4,570.88 | Facility | None | $162.18 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $245.47 | Professional | None | $154.88 | $194.98 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $162.18 | Facility | None | $151.36 | $158.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | None | $186.21 | $229.09 | $281.84 |
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 $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 $169.82 Median $218.78 Typical High $263.03 | Professional | None | $169.82 | $218.78 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $208.93 | Professional | None | $169.82 | $186.21 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $346.74 | Professional | None | $141.25 | $239.88 | $346.74 |
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 $147.91 Median $194.98 Typical High $288.40 | Professional | None | $147.91 | $194.98 | $288.40 |
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 $81.28 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $81.28 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $32.36 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $112.20 | $123.03 | $144.54 |
Where Utah sits
The same service costs 4.0 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
$186
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.