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 $57.54 Median $95.50 Typical High $4,570.88 | Facility | None | $57.54 | $95.50 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $91.20 | Professional | None | $56.23 | $70.79 | $91.20 |
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 $66.07 Median $91.20 Typical High $97.72 | Professional | None | $66.07 | $91.20 | $97.72 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $47.86 Typical High $66.07 | Professional | None | $25.12 | $47.86 | $66.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $85.11 | Professional | None | $58.88 | $72.44 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $69.18 | Professional | None | $57.54 | $61.66 | $69.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $107.15 | Professional | None | $46.77 | $79.43 | $107.15 |
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 $50.12 Median $64.57 Typical High $95.50 | Professional | None | $50.12 | $64.57 | $95.50 |
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 $28.18 Median $28.84 Typical High $41.69 | Professional | 52 · Reduced service | $28.18 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.48 Typical High $16.60 | Professional | 53 · Discontinued | $11.22 | $11.48 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $43.65 Typical High $61.66 | Professional | 54 · Surgery only | $41.69 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $12.30 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $8.32 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $38.90 Median $40.74 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $38.90 | $40.74 | $57.54 |
Where Utah sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 41st of 51
$64.57
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.