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 $776.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $776.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $776.25 | Professional | None | $602.56 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $794.33 | Professional | None | $660.69 | $676.08 | $794.33 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $295.12 Typical High $446.68 | Professional | None | $56.23 | $295.12 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $851.14 | Professional | None | $724.44 | $758.58 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,122.02 | Professional | None | $602.56 | $954.99 | $1,122.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $1,479.11 | Professional | None | $489.78 | $870.96 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $977.24 | Professional | None | $478.63 | $562.34 | $977.24 |
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 $323.59 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $549.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 7.6 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
$316
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.