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 $208.93 Median $2,951.21 Typical High $4,570.88 | Facility | None | $208.93 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $302.00 Typical High $524.81 | Professional | None | $147.91 | $302.00 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $891.25 | Facility | None | $851.14 | $870.96 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $457.09 | Professional | None | $177.83 | $338.84 | $457.09 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $251.19 Typical High $338.84 | Professional | None | $26.92 | $251.19 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,570.40 | $3,311.31 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $512.86 | Professional | None | $186.21 | $371.54 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $295.12 | Professional | None | $154.88 | $251.19 | $295.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $199.53 Median $467.74 Typical High $794.33 | Professional | None | $199.53 | $467.74 | $794.33 |
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 $134.90 Median $316.23 Typical High $537.03 | Professional | None | $134.90 | $316.23 | $537.03 |
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 $104.71 Median $147.91 Typical High $263.03 | Professional | 52 · Reduced service | $104.71 | $147.91 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $58.88 Typical High $104.71 | Professional | 53 · Discontinued | $41.69 | $58.88 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $218.78 Typical High $398.11 | Professional | 54 · Surgery only | $154.88 | $218.78 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $43.65 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $43.65 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $29.51 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.89 | $29.51 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $204.17 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $144.54 | $204.17 | $371.54 |
Where Utah sits
The same service costs 4.0 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· 48th of 51
$257
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.