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 $169.82 Median $2,884.03 Typical High $4,786.30 | Facility | None | $169.82 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $239.88 | Professional | None | $151.36 | $208.93 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $173.78 Typical High $177.83 | Facility | None | $165.96 | $173.78 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $331.13 | Professional | None | $199.53 | $269.15 | $331.13 |
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 $162.18 Median $251.19 Typical High $295.12 | Professional | None | $162.18 | $251.19 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | None | $162.18 | $173.78 | $186.21 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $407.38 | Professional | None | $154.88 | $275.42 | $407.38 |
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 $147.91 Median $218.78 Typical High $331.13 | Professional | None | $147.91 | $218.78 | $331.13 |
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 $77.62 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $77.62 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $31.62 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.85 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $169.82 |
Where Utah sits
The same service costs 3.5 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· 47th of 51
$191
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.