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 $69.18 Median $2,951.21 Typical High $4,570.88 | Facility | None | $69.18 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $190.55 | Professional | None | $69.18 | $134.90 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $229.09 | Professional | None | $79.43 | $147.91 | $229.09 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | None | $100.00 | $128.82 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $1,202.26 | Facility | None | $630.96 | $831.76 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $204.17 | Professional | None | $100.00 | $158.49 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $128.82 | Professional | None | $100.00 | $114.82 | $128.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $85.11 Median $186.21 Typical High $257.04 | Professional | None | $85.11 | $186.21 | $257.04 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $218.78 | Professional | None | $75.86 | $134.90 | $218.78 |
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 $34.67 Median $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $34.67 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $13.80 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $52.48 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $10.47 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.92 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $95.50 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $48.98 | $95.50 | $112.20 |
Where Utah sits
The same service costs 4.5 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· 41st of 51
$135
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.