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 $912.01 Median $2,884.03 Typical High $4,786.30 | Facility | None | $912.01 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,288.25 | $1,348.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,174.90 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $575.44 Typical High $851.14 | Professional | None | $85.11 | $575.44 | $851.14 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $5,495.41 | Facility | None | $3,019.95 | $3,801.89 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,288.25 | Professional | None | $912.01 | $1,071.52 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,047.13 | Professional | None | $891.25 | $954.99 | $1,047.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,737.80 | Professional | None | $707.95 | $1,202.26 | $1,737.80 |
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 $776.25 Median $977.24 Typical High $1,445.44 | Professional | None | $776.25 | $977.24 | $1,445.44 |
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 $426.58 Median $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $724.44 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in Texas. 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
$776
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.