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 $309.03 Median $2,951.21 Typical High $4,570.88 | Facility | None | $309.03 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $323.59 | Professional | None | $251.19 | $257.04 | $323.59 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $165.96 Typical High $223.87 | Professional | None | $26.30 | $165.96 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $380.19 | Professional | None | $316.23 | $338.84 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $512.86 | Professional | None | $263.03 | $436.52 | $512.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $660.69 | Professional | None | $213.80 | $398.11 | $660.69 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $371.54 | Professional | None | $194.98 | $234.42 | $371.54 |
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 $138.04 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $46.77 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $218.78 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 51st of 51
$191
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.