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 $1,174.90 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,174.90 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | None | $977.24 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $5,754.40 Median $5,888.44 Typical High $6,025.60 | Facility | None | $5,754.40 | $5,888.44 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,023.29 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $446.68 Typical High $676.08 | Professional | None | $56.23 | $446.68 | $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 $1,071.52 Median $1,122.02 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,122.02 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $1,621.81 | Professional | None | $891.25 | $1,380.38 | $1,621.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $2,089.30 | Professional | None | $794.33 | $1,288.25 | $2,089.30 |
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 $707.95 Median $870.96 Typical High $1,479.11 | Professional | None | $707.95 | $870.96 | $1,479.11 |
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 $489.78 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $831.76 | $831.76 |
Where Utah sits
The same service costs 17.8 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
$457
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.