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 $1,659.59 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,659.59 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,659.59 | $1,659.59 |
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 $1,318.26 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,380.38 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $537.03 Typical High $758.58 | Professional | None | $85.11 | $537.03 | $758.58 |
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 $1,258.93 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,348.96 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,659.59 | $1,949.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $912.01 Median $1,584.89 Typical High $3,235.94 | Professional | None | $912.01 | $1,584.89 | $3,235.94 |
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 $933.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $933.25 | $1,122.02 | $1,862.09 |
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 $588.84 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $891.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $177.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $117.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $831.76 | $1,148.15 | $1,148.15 |
Where Utah sits
The same service costs 7.9 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
$562
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.