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 $912.01 Median $4,570.88 Typical High $8,912.51 | Facility | None | $912.01 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | None | $776.25 | $912.01 | $912.01 |
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 $776.25 Median $776.25 Typical High $933.25 | Professional | None | $776.25 | $776.25 | $933.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $562.34 | Professional | None | $56.23 | $363.08 | $562.34 |
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 $870.96 Median $912.01 Typical High $1,023.29 | Professional | None | $870.96 | $912.01 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,348.96 | Professional | None | $724.44 | $1,148.15 | $1,348.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,698.24 | Professional | None | $616.60 | $1,096.48 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,148.15 | Professional | None | $524.81 | $676.08 | $1,148.15 |
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 $389.05 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $630.96 |
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 16.6 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
$389
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.