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 $257.04 Median $457.09 Typical High $4,570.88 | Facility | None | $257.04 | $457.09 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $457.09 | Professional | None | $223.87 | $338.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $575.44 | Professional | None | $281.84 | $489.78 | $575.44 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $213.80 Typical High $323.59 | Professional | None | $28.18 | $213.80 | $323.59 |
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 $234.42 Median $371.54 Typical High $478.63 | Professional | None | $234.42 | $371.54 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | None | $229.09 | $251.19 | $281.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $630.96 | Professional | None | $199.53 | $457.09 | $630.96 |
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 $208.93 Median $371.54 Typical High $616.60 | Professional | None | $208.93 | $371.54 | $616.60 |
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 $112.20 Median $162.18 Typical High $229.09 | Professional | 52 · Reduced service | $112.20 | $162.18 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $245.47 Typical High $338.84 | Professional | 54 · Surgery only | $169.82 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $48.98 Typical High $69.18 | Professional | 55 · Aftercare only | $33.88 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $229.09 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $158.49 | $229.09 | $316.23 |
Where Utah sits
The same service costs 4.6 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· 48th of 51
$257
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.