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 $398.11 Median $2,951.21 Typical High $4,570.88 | Facility | None | $398.11 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $446.68 | Professional | None | $302.00 | $398.11 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $165.96 | Facility | None | $154.88 | $162.18 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $416.87 | Professional | None | $331.13 | $354.81 | $416.87 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $190.55 Typical High $338.84 | Professional | None | $28.18 | $190.55 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Facility | None | $371.54 | $489.78 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | None | $398.11 | $457.09 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $645.65 | Professional | None | $331.13 | $549.54 | $645.65 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $776.25 | Professional | None | $275.42 | $512.86 | $776.25 |
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 $263.03 Median $309.03 Typical High $501.19 | Professional | None | $263.03 | $309.03 | $501.19 |
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 $173.78 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $70.79 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $302.00 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $741.31 Typical High $1,071.52 | Facility | 50 · Both sides | $562.34 | $741.31 | $1,071.52 |
Where Utah sits
The same service costs 5.8 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
$219
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.