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 $302.00 Median $2,884.03 Typical High $4,786.30 | Facility | None | $302.00 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $436.52 | Professional | None | $269.15 | $346.74 | $436.52 |
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 $346.74 Median $457.09 Typical High $537.03 | Professional | None | $346.74 | $457.09 | $537.03 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $288.40 Typical High $380.19 | Professional | None | $26.92 | $288.40 | $380.19 |
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 $302.00 Median $416.87 Typical High $489.78 | Professional | None | $302.00 | $416.87 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $346.74 | Professional | None | $302.00 | $316.23 | $346.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $645.65 | Professional | None | $263.03 | $467.74 | $645.65 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $575.44 | Professional | None | $269.15 | $380.19 | $575.44 |
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 $144.54 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $199.53 | $239.88 | $281.84 |
Where Utah sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 51st of 51
$324
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.