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 $1,995.26 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,995.26 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,623.41 | Facility | None | $5,370.32 | $5,495.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,698.24 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $707.95 Typical High $1,071.52 | Professional | None | $85.11 | $707.95 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $18,620.87 | Facility | None | $10,232.93 | $12,882.50 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,862.09 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,479.11 | $2,290.87 | $2,691.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $4,570.88 | Professional | None | $1,230.27 | $2,137.96 | $4,570.88 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,412.54 | $2,454.71 |
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 $794.33 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $316.23 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,380.38 | $1,380.38 |
Where Utah sits
The same service costs 18.6 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
$741
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.