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 $3,801.89 Median $4,570.88 Typical High $9,120.11 | Facility | None | $3,801.89 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,019.95 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,370.32 | $5,495.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,890.45 | Professional | None | $3,090.30 | $3,235.94 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,348.96 Typical High $1,995.26 | Professional | None | $194.98 | $1,348.96 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $18,620.87 | Facility | None | $10,232.93 | $12,882.50 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,548.13 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,265.80 Typical High $4,897.79 | Professional | None | $2,818.38 | $4,265.80 | $4,897.79 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $6,309.57 | Professional | None | $2,290.87 | $4,168.69 | $6,309.57 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $4,570.88 | Professional | None | $2,290.87 | $2,691.53 | $4,570.88 |
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 $1,513.56 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,513.56 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $602.56 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,238.72 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $446.68 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,630.27 | $2,630.27 |
Where Utah sits
The same service costs 8.7 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· 50th of 51
$1,413
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.