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 $125.89 Median $2,951.21 Typical High $4,570.88 | Facility | None | $125.89 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $151.36 | Professional | None | $123.03 | $125.89 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Facility | None | $93.33 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $144.54 | Professional | None | $109.65 | $131.83 | $144.54 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $102.33 | Professional | None | $72.44 | $85.11 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $186.21 | Professional | None | $114.82 | $158.49 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $173.78 | Professional | None | $95.50 | $147.91 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $251.19 | Professional | None | $85.11 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $177.83 | Professional | None | $79.43 | $104.71 | $177.83 |
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 $61.66 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $107.15 |
Where Utah sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 48th of 51
$105
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.