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 $138.04 Median $2,951.21 Typical High $4,570.88 | Facility | None | $138.04 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $229.09 | Professional | None | $123.03 | $177.83 | $229.09 |
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 $158.49 Median $223.87 Typical High $269.15 | Professional | None | $158.49 | $223.87 | $269.15 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $194.98 | Professional | None | $104.71 | $141.25 | $194.98 |
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 $128.82 Median $204.17 Typical High $239.88 | Professional | None | $128.82 | $204.17 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $151.36 | Professional | None | $128.82 | $138.04 | $151.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $331.13 | Professional | None | $125.89 | $223.87 | $331.13 |
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 $117.49 Median $177.83 Typical High $275.42 | Professional | None | $117.49 | $177.83 | $275.42 |
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 $63.10 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $63.10 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $25.12 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $93.33 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $18.62 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $87.10 | $117.49 | $138.04 |
Where Utah sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 46th of 51
$158
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.