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 $354.81 Median $2,951.21 Typical High $4,570.88 | Facility | None | $354.81 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $457.09 | Professional | None | $275.42 | $354.81 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $338.84 | Facility | None | $323.59 | $331.13 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $426.58 | Professional | None | $302.00 | $380.19 | $426.58 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $218.78 Typical High $338.84 | Professional | None | $28.18 | $218.78 | $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 $331.13 Median $467.74 Typical High $549.54 | Professional | None | $331.13 | $467.74 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $524.81 | Professional | None | $281.84 | $446.68 | $524.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $933.25 | Professional | None | $309.03 | $524.81 | $933.25 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $512.86 | Professional | None | $234.42 | $323.59 | $512.86 |
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 $177.83 Median $177.83 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $323.59 |
Where Utah sits
The same service costs 4.5 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
$251
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.