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 $870.96 Median $4,570.88 Typical High $8,912.51 | Facility | None | $870.96 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $891.25 | Professional | None | $741.31 | $758.58 | $891.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $323.59 Typical High $478.63 | Professional | None | $56.23 | $323.59 | $478.63 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $912.01 | Professional | None | $758.58 | $812.83 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,202.26 | Professional | None | $645.65 | $1,023.29 | $1,202.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $2,041.74 | Professional | None | $524.81 | $891.25 | $2,041.74 |
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 $537.03 Median $616.60 Typical High $1,023.29 | Professional | None | $537.03 | $616.60 | $1,023.29 |
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 $338.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $602.56 | $602.56 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 7.4 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
$347
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.