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 $95.50 Median $2,951.21 Typical High $4,570.88 | Facility | None | $95.50 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $158.49 | Professional | None | $87.10 | $125.89 | $158.49 |
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 $109.65 Median $162.18 Typical High $194.98 | Professional | None | $109.65 | $162.18 | $194.98 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $131.83 | Professional | None | $75.86 | $97.72 | $131.83 |
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 $93.33 Median $144.54 Typical High $177.83 | Professional | None | $93.33 | $144.54 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | None | $93.33 | $100.00 | $109.65 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $223.87 | Professional | None | $79.43 | $165.96 | $223.87 |
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 $85.11 Median $128.82 Typical High $199.53 | Professional | None | $85.11 | $128.82 | $199.53 |
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 $44.67 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $44.67 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $18.20 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $67.61 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.12 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $85.11 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $63.10 | $85.11 | $100.00 |
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
$112
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.