How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,349 to $15,849Professionalmedian $525 · 10th to 90th $59 to $912
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 $1,348.96 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,348.96 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,370.32 | $5,495.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,148.15 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $501.19 Typical High $741.31 | Professional | None | $56.23 | $501.19 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,258.93 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,548.82 | $1,819.70 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,187.76 | Professional | None | $870.96 | $1,445.44 | $2,187.76 |
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 $812.83 Median $954.99 Typical High $1,621.81 | Professional | None | $812.83 | $954.99 | $1,621.81 |
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 $537.03 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $933.25 | $933.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
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
$537
AK $3,890TX $490
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.