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 $70.79 Median $2,238.72 Typical High $4,570.88 | Facility | None | $70.79 | $2,238.72 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $128.82 | Professional | None | $70.79 | $102.33 | $128.82 |
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 $81.28 Median $123.03 Typical High $154.88 | Professional | None | $81.28 | $123.03 | $154.88 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $131.83 | Professional | None | $75.86 | $97.72 | $131.83 |
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 $74.13 Median $117.49 Typical High $141.25 | Professional | None | $74.13 | $117.49 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $89.13 | Professional | None | $72.44 | $79.43 | $89.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $60.26 Median $125.89 Typical High $169.82 | Professional | None | $60.26 | $125.89 | $169.82 |
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 $61.66 Median $97.72 Typical High $158.49 | Professional | None | $61.66 | $97.72 | $158.49 |
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 $35.48 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.50 Typical High $22.39 | Professional | 53 · Discontinued | $14.13 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $74.13 Typical High $83.18 | Professional | 54 · Surgery only | $53.70 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.79 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.77 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.08 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $69.18 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $50.12 | $69.18 | $77.62 |
Where Utah sits
The same service costs 3.9 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· 33rd of 51
$105
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.