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 $977.24 Median $4,570.88 Typical High $9,772.37 | Facility | None | $977.24 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | None | $812.83 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,023.29 | Professional | None | $831.76 | $851.14 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $562.34 | Professional | None | $56.23 | $363.08 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,071.52 | Professional | None | $912.01 | $954.99 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,412.54 | Professional | None | $758.58 | $1,202.26 | $1,412.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $2,398.83 | Professional | None | $616.60 | $1,096.48 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,202.26 | Professional | None | $616.60 | $724.44 | $1,202.26 |
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 $407.38 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $691.83 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 8.7 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
$398
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.