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 $104.71 Median $2,884.03 Typical High $4,786.30 | Facility | None | $104.71 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $165.96 | Professional | None | $104.71 | $131.83 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $128.82 | Facility | None | $120.23 | $125.89 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $194.98 | Professional | None | $117.49 | $147.91 | $194.98 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $131.83 | Professional | None | $75.86 | $97.72 | $131.83 |
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 $114.82 Median $151.36 Typical High $177.83 | Professional | None | $114.82 | $151.36 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | None | $112.20 | $125.89 | $141.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $229.09 | Professional | None | $95.50 | $162.18 | $229.09 |
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 $95.50 Median $128.82 Typical High $199.53 | Professional | None | $95.50 | $128.82 | $199.53 |
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 $51.29 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $51.29 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $93.33 Typical High $109.65 | Professional | 54 · Surgery only | $77.62 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $15.49 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $87.10 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $72.44 | $87.10 | $102.33 |
Where Utah sits
The same service costs 4.1 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· 44th of 51
$126
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.