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 $467.74 Median $2,951.21 Typical High $4,570.88 | Facility | None | $467.74 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $501.19 | Professional | None | $380.19 | $467.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $165.96 | Facility | None | $154.88 | $162.18 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $501.19 | Professional | None | $380.19 | $407.38 | $501.19 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $269.15 Typical High $398.11 | Professional | None | $28.18 | $269.15 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Facility | None | $371.54 | $489.78 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $616.60 | Professional | None | $478.63 | $549.54 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $758.58 | Professional | None | $398.11 | $645.65 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $954.99 | Professional | None | $331.13 | $616.60 | $954.99 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $602.56 | Professional | None | $302.00 | $363.08 | $602.56 |
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 $208.93 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $208.93 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $85.11 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $354.81 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $741.31 Typical High $1,071.52 | Facility | 50 · Both sides | $562.34 | $741.31 | $1,071.52 |
Where Utah sits
The same service costs 5.2 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
$302
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.