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 $151.36 Median $2,951.21 Typical High $4,570.88 | Facility | None | $151.36 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $234.42 | Professional | None | $144.54 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $158.49 | Facility | None | $147.91 | $154.88 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $269.15 | Professional | None | $169.82 | $213.80 | $269.15 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $194.98 | Professional | None | $104.71 | $141.25 | $194.98 |
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 $158.49 Median $204.17 Typical High $239.88 | Professional | None | $158.49 | $204.17 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | None | $154.88 | $169.82 | $190.55 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $338.84 | Professional | None | $131.83 | $223.87 | $338.84 |
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 $138.04 Median $181.97 Typical High $275.42 | Professional | None | $138.04 | $181.97 | $275.42 |
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 $75.86 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $112.20 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $104.71 | $117.49 | $138.04 |
Where Utah sits
The same service costs 3.9 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· 48th of 51
$166
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.