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 $870.96 Median $4,570.88 Typical High $9,120.11 | Facility | None | $870.96 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | None | $724.44 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | None | $741.31 | $741.31 | $891.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $316.23 Typical High $537.03 | Professional | None | $54.95 | $316.23 | $537.03 |
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 $812.83 Median $851.14 Typical High $954.99 | Professional | None | $812.83 | $851.14 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,258.93 | Professional | None | $676.08 | $1,071.52 | $1,258.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $1,621.81 | Professional | None | $549.54 | $977.24 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,071.52 | Professional | None | $537.03 | $630.96 | $1,071.52 |
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 $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $602.56 |
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 8.3 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
$355
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.