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 $467.74 Median $2,884.03 Typical High $4,786.30 | Facility | None | $467.74 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $794.33 | Professional | None | $467.74 | $691.83 | $794.33 |
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 $389.05 Median $660.69 Typical High $794.33 | Professional | None | $389.05 | $660.69 | $794.33 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $426.58 Typical High $645.65 | Professional | None | $56.23 | $426.58 | $645.65 |
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 $562.34 Median $891.25 Typical High $1,047.13 | Professional | None | $562.34 | $891.25 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $954.99 | Professional | None | $467.74 | $812.83 | $954.99 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,621.81 | Professional | None | $575.44 | $954.99 | $1,621.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $954.99 | Professional | None | $331.13 | $549.54 | $954.99 |
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 $234.42 Median $263.03 Typical High $398.11 | Professional | 52 · Reduced service | $234.42 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $158.49 | Professional | 53 · Discontinued | $95.50 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $389.05 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $120.23 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $52.48 Typical High $79.43 | Professional | 56 · Pre-op care only | $46.77 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $562.34 |
Where Utah sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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· 49th of 51
$468
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.