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 $2,691.53 Median $4,570.88 Typical High $9,120.11 | Facility | None | $2,691.53 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,511.89 | $2,691.53 | $4,073.80 |
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 $3,090.30 Median $3,090.30 Typical High $4,466.84 | Professional | None | $3,090.30 | $3,090.30 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,380.38 Typical High $1,995.26 | Professional | None | $194.98 | $1,380.38 | $1,995.26 |
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 $2,884.03 Median $3,311.31 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,311.31 | $3,981.07 |
Select Health Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,884.03 | $3,090.30 | $3,467.37 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $5,370.32 | Professional | None | $2,089.30 | $3,630.78 | $5,370.32 |
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 $2,290.87 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,754.23 | $4,466.84 |
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 $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,258.93 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $398.11 Typical High $407.38 | Professional | 55 · Aftercare only | $380.19 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $1,905.46 |
Where Utah sits
The same service costs 15.8 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
$1,622
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.