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 $338.84 Median $2,884.03 Typical High $4,786.30 | Facility | None | $338.84 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $467.74 | Professional | None | $316.23 | $371.54 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,479.11 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $549.54 | Professional | None | $389.05 | $446.68 | $549.54 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $302.00 Typical High $407.38 | Professional | None | $26.92 | $302.00 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,888.44 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $512.86 | Professional | None | $338.84 | $407.38 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $407.38 | Professional | None | $338.84 | $363.08 | $407.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $602.56 | Professional | None | $275.42 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $562.34 | Professional | None | $302.00 | $380.19 | $562.34 |
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 $162.18 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $162.18 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $223.87 | $234.42 | $275.42 |
Where Utah sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 50th of 51
$347
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.