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 $346.74 Median $3,162.28 Typical High $8,511.38 | Facility | None | $346.74 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $537.03 | Professional | None | $275.42 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $269.15 Typical High $275.42 | Facility | None | $251.19 | $269.15 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $588.84 | Professional | None | $398.11 | $512.86 | $588.84 |
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 $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 $275.42 Median $446.68 Typical High $524.81 | Professional | None | $275.42 | $446.68 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | None | $275.42 | $295.12 | $316.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $812.83 | Professional | None | $309.03 | $537.03 | $812.83 |
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 $257.04 Median $389.05 Typical High $602.56 | Professional | None | $257.04 | $389.05 | $602.56 |
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 $131.83 Median $186.21 Typical High $229.09 | Professional | 52 · Reduced service | $131.83 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $52.48 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $194.98 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $263.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $181.97 | $263.03 | $323.59 |
Where Utah sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$331
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.