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 $186.21 Median $2,884.03 Typical High $4,786.30 | Facility | None | $186.21 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $281.84 | Professional | None | $173.78 | $218.78 | $281.84 |
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 $213.80 Median $269.15 Typical High $331.13 | Professional | None | $213.80 | $269.15 | $331.13 |
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 $194.98 Median $251.19 Typical High $302.00 | Professional | None | $194.98 | $251.19 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | None | $194.98 | $213.80 | $239.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $416.87 | Professional | None | $162.18 | $281.84 | $416.87 |
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 $169.82 Median $223.87 Typical High $338.84 | Professional | None | $169.82 | $223.87 | $338.84 |
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 $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $93.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $128.82 | $141.25 | $165.96 |
Where Utah sits
The same service costs 4.7 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· 49th of 51
$219
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.