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 $389.05 Median $501.19 Typical High $4,570.88 | Facility | None | $389.05 | $501.19 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $501.19 | Professional | None | $371.54 | $398.11 | $501.19 |
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 $446.68 Median $562.34 Typical High $676.08 | Professional | None | $446.68 | $562.34 | $676.08 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $234.42 Typical High $371.54 | Professional | None | $27.54 | $234.42 | $371.54 |
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 $380.19 Median $478.63 Typical High $575.44 | Professional | None | $380.19 | $478.63 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | None | $380.19 | $407.38 | $446.68 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $724.44 | Professional | None | $323.59 | $537.03 | $724.44 |
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 $338.84 Median $446.68 Typical High $676.08 | Professional | None | $338.84 | $446.68 | $676.08 |
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 $186.21 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $186.21 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $100.00 | Professional | 53 · Discontinued | $74.13 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $275.42 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $50.12 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $354.81 |
Where Utah sits
The same service costs 6.0 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
$324
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.