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 $371.54 Median $2,951.21 Typical High $4,570.88 | Facility | None | $371.54 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $407.38 | Professional | None | $295.12 | $371.54 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $162.18 | Facility | None | $154.88 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | None | $316.23 | $338.84 | $398.11 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $165.96 Typical High $331.13 | Professional | None | $26.92 | $165.96 | $331.13 |
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 $380.19 Median $426.58 Typical High $478.63 | Professional | None | $380.19 | $426.58 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $602.56 | Professional | None | $316.23 | $512.86 | $602.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $724.44 | Professional | None | $257.04 | $489.78 | $724.44 |
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 $245.47 Median $295.12 Typical High $478.63 | Professional | None | $245.47 | $295.12 | $478.63 |
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 $165.96 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $288.40 |
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 5.8 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
$219
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.