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 $3,890.45 Median $4,570.88 Typical High $12,302.69 | Facility | None | $3,890.45 | $4,570.88 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,818.38 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $10,471.29 Median $10,964.78 Typical High $11,220.18 | Facility | None | $10,471.29 | $10,964.78 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $3,715.35 | Professional | None | $2,951.21 | $3,311.31 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,380.38 Typical High $1,905.46 | Professional | None | $194.98 | $1,380.38 | $1,905.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $26,302.68 Median $32,359.37 Typical High $47,863.01 | Facility | None | $26,302.68 | $32,359.37 | $47,863.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $4,570.88 | Professional | None | $3,890.45 | $4,168.69 | $4,570.88 |
Select Health Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Select Health Setting Professional Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $5,888.44 | Professional | None | $2,630.27 | $5,011.87 | $5,888.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2,187.76 Median $3,981.07 Typical High $7,079.46 | Professional | None | $2,187.76 | $3,981.07 | $7,079.46 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $11,481.54 Typical High $24,547.09 | Facility | None | $2,691.53 | $11,481.54 | $24,547.09 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,570.40 | $4,365.16 |
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 $1,412.54 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,412.54 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $562.34 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,137.96 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $426.58 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $281.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,754.23 | $2,754.23 |
Where Utah sits
The same service costs 25.7 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
$1,413
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.