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 $234.42 Median $2,951.21 Typical High $4,570.88 | Facility | None | $234.42 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $338.84 | Professional | None | $218.78 | $263.03 | $338.84 |
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 $269.15 Median $323.59 Typical High $398.11 | Professional | None | $269.15 | $323.59 | $398.11 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $169.82 Typical High $257.04 | Professional | None | $26.30 | $169.82 | $257.04 |
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 $245.47 Median $302.00 Typical High $371.54 | Professional | None | $245.47 | $302.00 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | None | $239.88 | $257.04 | $288.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $467.74 | Professional | None | $199.53 | $338.84 | $467.74 |
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 $213.80 Median $275.42 Typical High $407.38 | Professional | None | $213.80 | $275.42 | $407.38 |
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 $117.49 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $173.78 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $162.18 | $173.78 | $199.53 |
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· 49th of 51
$245
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.