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 $407.38 Median $2,951.21 Typical High $4,570.88 | Facility | None | $407.38 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $446.68 | Professional | None | $302.00 | $407.38 | $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 $338.84 Median $371.54 Typical High $426.58 | Professional | None | $338.84 | $371.54 | $426.58 |
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 $407.38 Median $467.74 Typical High $512.86 | Professional | None | $407.38 | $467.74 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $660.69 | Professional | None | $338.84 | $562.34 | $660.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $741.31 | Professional | None | $281.84 | $512.86 | $741.31 |
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 $269.15 Median $316.23 Typical High $524.81 | Professional | None | $269.15 | $316.23 | $524.81 |
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 $177.83 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $70.79 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $288.40 | $316.23 |
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 5.9 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.