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 $363.08 Median $389.05 Typical High $4,570.88 | Facility | None | $363.08 | $389.05 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $446.68 | Professional | None | $281.84 | $363.08 | $446.68 |
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 $295.12 Median $316.23 Typical High $389.05 | Professional | None | $295.12 | $316.23 | $389.05 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $190.55 Typical High $281.84 | Professional | None | $28.18 | $190.55 | $281.84 |
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 $467.74 | Professional | None | $380.19 | $426.58 | $467.74 |
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 $537.03 Typical High $616.60 | Professional | None | $316.23 | $537.03 | $616.60 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $691.83 | Professional | None | $257.04 | $478.63 | $691.83 |
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 $239.88 Median $281.84 Typical High $467.74 | Professional | None | $239.88 | $281.84 | $467.74 |
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 $165.96 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $165.96 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $269.15 |
Where Utah sits
The same service costs 5.6 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
$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.