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 $758.58 Median $3,388.44 Typical High $6,025.60 | Facility | None | $758.58 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,630.27 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | None | $645.65 | $645.65 | $794.33 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $309.03 Typical High $457.09 | Professional | None | $56.23 | $309.03 | $457.09 |
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 $724.44 Median $776.25 Typical High $851.14 | Professional | None | $724.44 | $776.25 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,122.02 | Professional | None | $616.60 | $954.99 | $1,122.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $1,905.46 | Professional | None | $467.74 | $891.25 | $1,905.46 |
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 $467.74 Median $562.34 Typical High $954.99 | Professional | None | $467.74 | $562.34 | $954.99 |
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 $323.59 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $537.03 |
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 7.9 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
$331
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.