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 $223.87 Median $2,884.03 Typical High $4,786.30 | Facility | None | $223.87 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $380.19 | Professional | None | $208.93 | $295.12 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $478.63 | Facility | None | $446.68 | $467.74 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $436.52 | Professional | None | $257.04 | $354.81 | $436.52 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $213.80 Typical High $281.84 | Professional | None | $26.92 | $213.80 | $281.84 |
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 $223.87 Median $331.13 Typical High $389.05 | Professional | None | $223.87 | $331.13 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $263.03 | Professional | None | $223.87 | $239.88 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $501.19 | Professional | None | $194.98 | $371.54 | $501.19 |
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 $194.98 Median $288.40 Typical High $446.68 | Professional | None | $194.98 | $288.40 | $446.68 |
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 $109.65 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $109.65 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $43.65 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $162.18 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.88 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $190.55 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $151.36 | $190.55 | $223.87 |
Where Utah sits
The same service costs 3.6 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· 50th 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.