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 $575.44 Median $2,884.03 Typical High $4,786.30 | Facility | None | $575.44 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $707.95 | Professional | None | $426.58 | $575.44 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,737.80 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $616.60 | Professional | None | $478.63 | $549.54 | $616.60 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $257.04 Typical High $416.87 | Professional | None | $28.18 | $257.04 | $416.87 |
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 $457.09 Median $588.84 Typical High $691.83 | Professional | None | $457.09 | $588.84 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $707.95 | Professional | None | $389.05 | $602.56 | $707.95 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,174.90 | Professional | None | $407.38 | $660.69 | $1,174.90 |
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 $354.81 Median $457.09 Typical High $741.31 | Professional | None | $354.81 | $457.09 | $741.31 |
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 $239.88 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $501.19 |
Where Utah sits
The same service costs 6.0 times more in Alaska than in Utah. 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· 51st of 51
$295
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.