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 $524.81 Median $2,951.21 Typical High $4,570.88 | Facility | None | $524.81 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $575.44 | Professional | None | $446.68 | $524.81 | $575.44 |
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 $446.68 Median $478.63 Typical High $562.34 | Professional | None | $446.68 | $478.63 | $562.34 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $275.42 Typical High $407.38 | Professional | None | $28.18 | $275.42 | $407.38 |
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 $512.86 Median $602.56 Typical High $660.69 | Professional | None | $512.86 | $602.56 | $660.69 |
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 $436.52 Median $691.83 Typical High $812.83 | Professional | None | $436.52 | $691.83 | $812.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $1,023.29 | Professional | None | $389.05 | $676.08 | $1,023.29 |
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 $338.84 Median $407.38 Typical High $660.69 | Professional | None | $338.84 | $407.38 | $660.69 |
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 $229.09 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $398.11 |
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 5.4 times more in Alaska than in Utah. 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· 51st of 51
$324
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.