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 $154.88 Median $2,951.21 Typical High $4,570.88 | Facility | None | $154.88 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $229.09 | Professional | None | $141.25 | $190.55 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Facility | None | $147.91 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $288.40 | Professional | None | $177.83 | $245.47 | $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 $144.54 Median $223.87 Typical High $263.03 | Professional | None | $144.54 | $223.87 | $263.03 |
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 $144.54 Median $154.88 Typical High $165.96 | Professional | None | $144.54 | $154.88 | $165.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $331.13 | Professional | None | $128.82 | $245.47 | $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 $131.83 Median $194.98 Typical High $295.12 | Professional | None | $131.83 | $194.98 | $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 $70.79 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $70.79 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $104.71 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $97.72 | $125.89 | $151.36 |
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· 45th of 51
$178
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.