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 $851.14 Median $4,570.88 Typical High $8,912.51 | Facility | None | $851.14 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | None | $691.83 | $851.14 | $851.14 |
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 $707.95 Median $724.44 Typical High $851.14 | Professional | None | $707.95 | $724.44 | $851.14 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $309.03 Typical High $501.19 | Professional | None | $56.23 | $309.03 | $501.19 |
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 $776.25 Median $831.76 Typical High $912.01 | Professional | None | $776.25 | $831.76 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,202.26 | Professional | None | $660.69 | $1,023.29 | $1,202.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $2,238.72 | Professional | None | $537.03 | $933.25 | $2,238.72 |
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 $512.86 Median $616.60 Typical High $1,023.29 | Professional | None | $512.86 | $616.60 | $1,023.29 |
6 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 $346.74 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $588.84 |
Where Utah sits
The same service costs 8.1 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
$331
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.