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 $1,778.28 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,778.28 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,659.59 | $1,778.28 | $1,778.28 |
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 $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $758.58 Typical High $1,122.02 | Professional | None | $114.82 | $758.58 | $1,122.02 |
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 $1,819.70 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,819.70 | $1,905.46 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,398.83 | $2,818.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $4,786.30 | Professional | None | $1,148.15 | $2,137.96 | $4,786.30 |
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 $1,096.48 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,412.54 | $2,398.83 |
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 $812.83 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,230.27 | $1,230.27 |
Where Utah sits
The same service costs 17.0 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
$794
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.