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 $338.84 Median $2,951.21 Typical High $4,570.88 | Facility | None | $338.84 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $363.08 | Professional | None | $263.03 | $338.84 | $363.08 |
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 $281.84 Median $295.12 Typical High $354.81 | Professional | None | $281.84 | $295.12 | $354.81 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $165.96 Typical High $257.04 | Professional | None | $28.18 | $165.96 | $257.04 |
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 $346.74 Median $380.19 Typical High $426.58 | Professional | None | $346.74 | $380.19 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $562.34 | Professional | None | $288.40 | $478.63 | $562.34 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $616.60 | Professional | None | $229.09 | $436.52 | $616.60 |
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 $218.78 Median $263.03 Typical High $426.58 | Professional | None | $218.78 | $263.03 | $426.58 |
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 $151.36 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $60.26 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $251.19 |
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 5.9 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
$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.