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 $1,949.84 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,949.84 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,659.59 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $691.83 Typical High $1,000.00 | Professional | None | $85.11 | $691.83 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,332.54 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,778.28 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Select Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $3,235.94 | Professional | None | $1,412.54 | $2,754.23 | $3,235.94 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $4,365.16 | Professional | None | $1,174.90 | $2,041.74 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,348.96 | $2,290.87 |
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 $758.58 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $758.58 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $309.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,148.15 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,380.38 | $1,380.38 |
Where Utah sits
The same service costs 15.1 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
$724
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.