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 $117.49 Median $2,951.21 Typical High $4,570.88 | Facility | None | $117.49 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $194.98 | Professional | None | $109.65 | $154.88 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $128.82 | Facility | None | $123.03 | $125.89 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $229.09 | Professional | None | $134.90 | $190.55 | $229.09 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $165.96 | Professional | None | $100.00 | $128.82 | $165.96 |
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 $112.20 Median $173.78 Typical High $208.93 | Professional | None | $112.20 | $173.78 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $128.82 | Professional | None | $112.20 | $120.23 | $128.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $263.03 | Professional | None | $97.72 | $190.55 | $263.03 |
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 $102.33 Median $151.36 Typical High $234.42 | Professional | None | $102.33 | $151.36 | $234.42 |
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 $53.70 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $53.70 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $21.88 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.96 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $100.00 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $100.00 | $117.49 |
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· 46th of 51
$138
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.