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 $50.12 Median $52.48 Typical High $4,570.88 | Facility | None | $50.12 | $52.48 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $57.54 | Professional | None | $45.71 | $50.12 | $57.54 |
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 $58.88 Median $60.26 Typical High $77.62 | Professional | None | $58.88 | $60.26 | $77.62 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | None | $48.98 | $56.23 | $69.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $123.03 Typical High $154.88 | Facility | None | $93.33 | $123.03 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $74.13 | Professional | None | $52.48 | $61.66 | $74.13 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | None | $52.48 | $56.23 | $61.66 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $87.10 | Professional | None | $39.81 | $66.07 | $87.10 |
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 $41.69 Median $51.29 Typical High $77.62 | Professional | None | $41.69 | $51.29 | $77.62 |
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 $22.91 Median $25.12 Typical High $26.30 | Professional | 52 · Reduced service | $22.91 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.00 Typical High $10.47 | Professional | 53 · Discontinued | $9.12 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $37.15 Typical High $38.90 | Professional | 54 · Surgery only | $34.67 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.41 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.01 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.57 | $5.01 | $5.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $34.67 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $32.36 | $34.67 | $36.31 |
Where Utah sits
The same service costs 4.6 times more in Alaska than in New York. 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· 26th of 51
$58.88
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.