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 $933.25 Median $3,162.28 Typical High $9,332.54 | Facility | None | $933.25 | $3,162.28 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,174.90 | Professional | None | $724.44 | $933.25 | $1,174.90 |
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 $794.33 Median $891.25 Typical High $1,047.13 | Professional | None | $794.33 | $891.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $467.74 Typical High $676.08 | Professional | None | $85.11 | $467.74 | $676.08 |
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 $758.58 Median $977.24 Typical High $1,148.15 | Professional | None | $758.58 | $977.24 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,148.15 | Professional | None | $645.65 | $1,000.00 | $1,148.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,290.87 | Professional | None | $691.83 | $1,122.02 | $2,290.87 |
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 $562.34 Median $741.31 Typical High $1,174.90 | Professional | None | $562.34 | $741.31 | $1,174.90 |
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 $416.87 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $416.87 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $234.42 | Professional | 53 · Discontinued | $165.96 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $870.96 | Professional | 54 · Surgery only | $630.96 | $691.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $812.83 |
Where Utah sits
The same service costs 6.2 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
$525
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.