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 $3,162.28 Typical High $8,511.38 | Facility | None | $302.00 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $467.74 | Professional | None | $245.47 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $489.78 Typical High $501.19 | Facility | None | $457.09 | $489.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $549.54 | Professional | None | $346.74 | $467.74 | $549.54 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $263.03 Typical High $346.74 | Professional | None | $26.92 | $263.03 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Facility | None | $977.24 | $1,258.93 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $489.78 | Professional | None | $263.03 | $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 $263.03 Median $281.84 Typical High $309.03 | Professional | None | $263.03 | $281.84 | $309.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $758.58 | Professional | None | $288.40 | $501.19 | $758.58 |
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 $239.88 Median $363.08 Typical High $562.34 | Professional | None | $239.88 | $363.08 | $562.34 |
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 $125.89 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $125.89 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $50.12 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $186.21 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.12 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $173.78 | $245.47 | $288.40 |
Where Utah sits
The same service costs 3.3 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
$302
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.