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 $288.40 Median $2,884.03 Typical High $4,786.30 | Facility | None | $288.40 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $436.52 | Professional | None | $239.88 | $346.74 | $436.52 |
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 $338.84 Median $416.87 Typical High $537.03 | Professional | None | $338.84 | $416.87 | $537.03 |
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 $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 $257.04 Median $407.38 Typical High $478.63 | Professional | None | $257.04 | $407.38 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $295.12 | Professional | None | $257.04 | $275.42 | $295.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $758.58 | Professional | None | $281.84 | $478.63 | $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 $234.42 Median $354.81 Typical High $549.54 | Professional | None | $234.42 | $354.81 | $549.54 |
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 $123.03 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $123.03 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $257.04 Typical High $281.84 | Professional | 54 · Surgery only | $186.21 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $24.55 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $173.78 | $239.88 | $263.03 |
Where Utah sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 47th 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.