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 $234.42 Median $2,951.21 Typical High $4,570.88 | Facility | None | $234.42 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None | $234.42 | $234.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $173.78 Typical High $177.83 | Facility | None | $165.96 | $173.78 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $269.15 | Professional | None | $204.17 | $251.19 | $269.15 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $194.98 | Professional | None | $125.89 | $158.49 | $194.98 |
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 $199.53 Median $281.84 Typical High $331.13 | Professional | None | $199.53 | $281.84 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $309.03 | Professional | None | $169.82 | $263.03 | $309.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $512.86 | Professional | None | $173.78 | $302.00 | $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 $151.36 Median $204.17 Typical High $316.23 | Professional | None | $151.36 | $204.17 | $316.23 |
7 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 $117.49 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $223.87 | Professional | 54 · Surgery only | $173.78 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $165.96 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $162.18 | $165.96 | $208.93 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $5,011.87 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $5,011.87 | $7,244.36 |
Where Utah sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$174
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.