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 $123.03 Median $2,951.21 Typical High $4,570.88 | Facility | None | $123.03 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $204.17 | Professional | None | $123.03 | $177.83 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $165.96 Typical High $169.82 | Facility | None | $158.49 | $165.96 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $269.15 | Professional | None | $141.25 | $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 $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 $131.83 Median $208.93 Typical High $245.47 | Professional | None | $131.83 | $208.93 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $158.49 | Professional | None | $131.83 | $141.25 | $158.49 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $323.59 | Professional | None | $104.71 | $229.09 | $323.59 |
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 $114.82 Median $177.83 Typical High $275.42 | Professional | None | $114.82 | $177.83 | $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 $61.66 Median $87.10 Typical High $95.50 | Professional | 52 · Reduced service | $61.66 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $24.55 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $93.33 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $123.03 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $87.10 | $123.03 | $134.90 |
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· 49th of 51
$155
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.