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 $575.44 Median $3,162.28 Typical High $4,570.88 | Facility | None | $575.44 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | None | $478.63 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | None | $478.63 | $478.63 | $575.44 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $229.09 Typical High $346.74 | Professional | None | $28.18 | $229.09 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $645.65 | Professional | None | $549.54 | $575.44 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $851.14 | Professional | None | $457.09 | $724.44 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $363.08 Median $660.69 Typical High $1,122.02 | Professional | None | $363.08 | $660.69 | $1,122.02 |
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 $346.74 Median $426.58 Typical High $707.95 | Professional | None | $346.74 | $426.58 | $707.95 |
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 $239.88 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $398.11 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
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
$245
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.