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 $2,137.96 Median $4,570.88 Typical High $9,772.37 | Facility | None | $2,137.96 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,995.26 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,778.28 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $1,023.29 Typical High $1,513.56 | Professional | None | $138.04 | $1,023.29 | $1,513.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $18,620.87 | Facility | None | $10,232.93 | $12,882.50 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $2,630.27 | Professional | None | $2,238.72 | $2,398.83 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $3,715.35 | Professional | None | $1,905.46 | $3,162.28 | $3,715.35 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $2,884.03 Typical High $4,677.35 | Professional | None | $1,513.56 | $2,884.03 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,698.24 | $2,951.21 |
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 $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,000.00 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,479.11 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,479.11 | $1,479.11 |
Where Utah sits
The same service costs 11.2 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
$1,072
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.