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 $2,290.87 Median $4,570.88 Typical High $9,120.11 | Facility | None | $2,290.87 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,905.46 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,365.16 | $4,570.88 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,905.46 | $1,949.84 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $812.83 Typical High $1,174.90 | Professional | None | $114.82 | $812.83 | $1,174.90 |
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 $2,041.74 Median $2,187.76 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,187.76 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,570.40 | $3,019.95 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $5,128.61 | Professional | None | $1,445.44 | $2,454.71 | $5,128.61 |
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 $1,380.38 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,659.59 | $2,818.38 |
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 $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,621.81 | $1,621.81 |
Where Utah sits
The same service costs 20.4 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
$851
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.