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 $1,288.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,288.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,288.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $489.78 Typical High $724.44 | Professional | None | $56.23 | $489.78 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,230.27 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $1,778.28 | Professional | None | $977.24 | $1,513.56 | $1,778.28 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $3,090.30 | Professional | None | $794.33 | $1,479.11 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,548.82 | Professional | None | $776.25 | $933.25 | $1,548.82 |
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 $524.81 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $891.25 | $891.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 17.4 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
$513
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.