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 $1,023.29 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,023.29 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,023.29 | Professional | None | $851.14 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $8,128.31 Typical High $8,128.31 | Facility | None | $7,762.47 | $8,128.31 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,023.29 | Professional | None | $851.14 | $870.96 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $389.05 Typical High $588.84 | Professional | None | $56.23 | $389.05 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $20,417.38 Median $25,118.86 Typical High $37,153.52 | Facility | None | $20,417.38 | $25,118.86 | $37,153.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,096.48 | Professional | None | $933.25 | $1,000.00 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,445.44 | Professional | None | $794.33 | $1,230.27 | $1,445.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $645.65 Median $1,148.15 Typical High $2,754.23 | Professional | None | $645.65 | $1,148.15 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,258.93 | Professional | None | $588.84 | $741.31 | $1,258.93 |
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 $416.87 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $707.95 | $707.95 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $30,199.52 Median $38,018.94 Typical High $54,954.09 | Facility | 50 · Both sides | $30,199.52 | $38,018.94 | $54,954.09 |
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
$427
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.