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 $371.54 Median $467.74 Typical High $537.03 | Professional | None | $371.54 | $467.74 | $537.03 |
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 $389.05 Median $426.58 Typical High $489.78 | Professional | None | $389.05 | $426.58 | $489.78 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $251.19 Typical High $398.11 | Professional | None | $28.18 | $251.19 | $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 $457.09 Median $537.03 Typical High $588.84 | Professional | None | $457.09 | $537.03 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $741.31 | Professional | None | $389.05 | $630.96 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $851.14 | Professional | None | $323.59 | $588.84 | $851.14 |
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 $309.03 Median $363.08 Typical High $588.84 | Professional | None | $309.03 | $363.08 | $588.84 |
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 $204.17 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $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 5.1 times more in Alaska than in Utah. 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· 51st of 51
$288
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.