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 $204.17 Median $2,951.21 Typical High $4,570.88 | Facility | None | $204.17 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $331.13 | Professional | None | $190.55 | $263.03 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $213.80 | Facility | None | $199.53 | $208.93 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $389.05 | Professional | None | $234.42 | $323.59 | $389.05 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $186.21 Typical High $251.19 | Professional | None | $26.92 | $186.21 | $251.19 |
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 $204.17 Median $295.12 Typical High $346.74 | Professional | None | $204.17 | $295.12 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | None | $204.17 | $218.78 | $239.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $446.68 | Professional | None | $177.83 | $331.13 | $446.68 |
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 $177.83 Median $257.04 Typical High $407.38 | Professional | None | $177.83 | $257.04 | $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 $97.72 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $97.72 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $57.54 | Professional | 53 · Discontinued | $39.81 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $147.91 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $138.04 | $169.82 | $199.53 |
Where Utah sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$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.