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 $398.11 Median $2,951.21 Typical High $4,570.88 | Facility | None | $398.11 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $537.03 | Professional | None | $380.19 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $323.59 | Facility | None | $295.12 | $316.23 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $467.74 | Professional | None | $331.13 | $426.58 | $467.74 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $194.98 Typical High $316.23 | Professional | None | $28.18 | $194.98 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
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 $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $512.86 | Professional | None | $281.84 | $436.52 | $512.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $831.76 | Professional | None | $288.40 | $512.86 | $831.76 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $562.34 | Professional | None | $251.19 | $346.74 | $562.34 |
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 $190.55 Median $199.53 Typical High $269.15 | Professional | 52 · Reduced service | $190.55 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $75.86 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $407.38 | Professional | 54 · Surgery only | $288.40 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $53.70 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $380.19 |
Where Utah sits
The same service costs 5.2 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
$234
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.