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 $776.25 Median $4,570.88 Typical High $9,772.37 | Facility | None | $776.25 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $776.25 | Professional | None | $562.34 | $776.25 | $776.25 |
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 $616.60 Median $660.69 Typical High $758.58 | Professional | None | $616.60 | $660.69 | $758.58 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $275.42 Typical High $371.54 | Professional | None | $56.23 | $275.42 | $371.54 |
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 $630.96 Median $660.69 Typical High $741.31 | Professional | None | $630.96 | $660.69 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $954.99 | Professional | None | $524.81 | $812.83 | $954.99 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $426.58 Median $758.58 Typical High $2,290.87 | Professional | None | $426.58 | $758.58 | $2,290.87 |
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 $446.68 Median $524.81 Typical High $870.96 | Professional | None | $446.68 | $524.81 | $870.96 |
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 $281.84 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $56.23 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $389.05 | $549.54 | $549.54 |
Where Utah sits
The same service costs 18.2 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
$288
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.