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 $302.00 Median $2,884.03 Typical High $4,786.30 | Facility | None | $302.00 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $416.87 | Professional | None | $275.42 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $229.09 Typical High $229.09 | Facility | None | $218.78 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $501.19 | Professional | None | $354.81 | $436.52 | $501.19 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $239.88 Typical High $316.23 | Professional | None | $26.92 | $239.88 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Facility | None | $977.24 | $1,258.93 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $446.68 | Professional | None | $288.40 | $380.19 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $331.13 | Professional | None | $288.40 | $309.03 | $331.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $575.44 | Professional | None | $251.19 | $426.58 | $575.44 |
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 $257.04 Median $346.74 Typical High $524.81 | Professional | None | $257.04 | $346.74 | $524.81 |
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 $138.04 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $138.04 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $208.93 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $263.03 |
Where Utah sits
The same service costs 4.0 times more in Alaska than in Texas. 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
$288
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.