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 $147.91 Median $2,951.21 Typical High $4,570.88 | Facility | None | $147.91 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $223.87 | Professional | None | $128.82 | $177.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $158.49 | Facility | None | $151.36 | $154.88 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $288.40 | Professional | None | $169.82 | $239.88 | $288.40 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $199.53 | Professional | None | $125.89 | $162.18 | $199.53 |
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 $141.25 Median $218.78 Typical High $257.04 | Professional | None | $141.25 | $218.78 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | None | $138.04 | $147.91 | $158.49 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $354.81 | Professional | None | $134.90 | $239.88 | $354.81 |
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 $125.89 Median $190.55 Typical High $295.12 | Professional | None | $125.89 | $190.55 | $295.12 |
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 $67.61 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $67.61 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $100.00 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $93.33 | $125.89 | $147.91 |
Where Utah sits
The same service costs 3.5 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
$170
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.