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 $933.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $933.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $2,570.40 | Facility | None | $2,454.71 | $2,511.89 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | None | $758.58 | $758.58 | $977.24 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $363.08 Typical High $562.34 | Professional | None | $56.23 | $363.08 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,047.13 | Professional | None | $891.25 | $954.99 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,380.38 | Professional | None | $758.58 | $1,174.90 | $1,380.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $2,344.23 | Professional | None | $616.60 | $1,071.52 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,174.90 | Professional | None | $575.44 | $691.83 | $1,174.90 |
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 $398.11 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $660.69 | $660.69 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 8.5 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
$398
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.