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 $380.19 Median $501.19 Typical High $4,570.88 | Facility | None | $380.19 | $501.19 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $501.19 | Professional | None | $354.81 | $426.58 | $501.19 |
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 $426.58 Median $549.54 Typical High $660.69 | Professional | None | $426.58 | $549.54 | $660.69 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $269.15 Typical High $416.87 | Professional | None | $28.18 | $269.15 | $416.87 |
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 $501.19 Typical High $602.56 | Professional | None | $380.19 | $501.19 | $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 $380.19 Median $407.38 Typical High $457.09 | Professional | None | $380.19 | $407.38 | $457.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $758.58 | Professional | None | $288.40 | $562.34 | $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 $331.13 Median $467.74 Typical High $707.95 | Professional | None | $331.13 | $467.74 | $707.95 |
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 $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $186.21 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $74.13 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $281.84 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $263.03 | $295.12 | $346.74 |
Where Utah sits
The same service costs 4.7 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
$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.