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 $416.87 Median $562.34 Typical High $4,570.88 | Facility | None | $416.87 | $562.34 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $562.34 | Professional | None | $389.05 | $436.52 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $380.19 Typical High $389.05 | Facility | None | $363.08 | $380.19 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $776.25 | Professional | None | $489.78 | $645.65 | $776.25 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $281.84 Typical High $407.38 | Professional | None | $28.18 | $281.84 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,888.44 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $602.56 | Professional | None | $398.11 | $512.86 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $467.74 | Professional | None | $389.05 | $416.87 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $933.25 | Professional | None | $346.74 | $575.44 | $933.25 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $794.33 | Professional | None | $371.54 | $489.78 | $794.33 |
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 $194.98 Median $218.78 Typical High $281.84 | Professional | 52 · Reduced service | $194.98 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $114.82 | Professional | 53 · Discontinued | $77.62 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $331.13 Typical High $426.58 | Professional | 54 · Surgery only | $288.40 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $85.11 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $309.03 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $269.15 | $309.03 | $398.11 |
Where Utah sits
The same service costs 5.1 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
$355
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.