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 $229.09 Median $2,951.21 Typical High $4,570.88 | Facility | None | $229.09 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $354.81 | Professional | None | $218.78 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $223.87 Typical High $229.09 | Facility | None | $213.80 | $223.87 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $309.03 | Professional | None | $194.98 | $263.03 | $309.03 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $186.21 Typical High $251.19 | Professional | None | $26.92 | $186.21 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,570.40 | $3,311.31 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $371.54 | Professional | None | $194.98 | $316.23 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $295.12 | Professional | None | $165.96 | $257.04 | $295.12 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $512.86 | Professional | None | $190.55 | $309.03 | $512.86 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $363.08 | Professional | None | $144.54 | $229.09 | $363.08 |
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 $114.82 Median $114.82 Typical High $177.83 | Professional | 52 · Reduced service | $114.82 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $70.79 | Professional | 53 · Discontinued | $45.71 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $169.82 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $251.19 |
Where Utah sits
The same service costs 4.4 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
$195
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.