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 $660.69 Median $3,162.28 Typical High $4,570.88 | Facility | None | $660.69 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | None | $562.34 | $660.69 | $660.69 |
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 $549.54 Median $549.54 Typical High $676.08 | Professional | None | $549.54 | $549.54 | $676.08 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $269.15 Typical High $416.87 | Professional | None | $56.23 | $269.15 | $416.87 |
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 $645.65 Median $676.08 Typical High $758.58 | Professional | None | $645.65 | $676.08 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,000.00 | Professional | None | $537.03 | $851.14 | $1,000.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,148.15 | Professional | None | $416.87 | $758.58 | $1,148.15 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $831.76 | Professional | None | $398.11 | $489.78 | $831.76 |
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 $281.84 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $457.09 |
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 7.6 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
$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.