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 $851.14 Median $4,570.88 Typical High $9,772.37 | Facility | None | $851.14 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,398.83 | $2,454.71 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,000.00 | Professional | None | $758.58 | $758.58 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $389.05 Typical High $588.84 | Professional | None | $56.23 | $389.05 | $588.84 |
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 $912.01 Median $977.24 Typical High $1,071.52 | Professional | None | $912.01 | $977.24 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,412.54 | Professional | None | $776.25 | $1,202.26 | $1,412.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,995.26 | Professional | None | $588.84 | $1,122.02 | $1,995.26 |
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 $575.44 Median $724.44 Typical High $1,202.26 | Professional | None | $575.44 | $724.44 | $1,202.26 |
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 $416.87 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $575.44 | $588.84 | $588.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $15,488.17 Median $19,498.45 Typical High $28,183.83 | Facility | 50 · Both sides | $15,488.17 | $19,498.45 | $28,183.83 |
Where Utah sits
The same service costs 7.6 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
$427
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.