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 $346.74 Median $2,884.03 Typical High $4,786.30 | Facility | None | $346.74 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $512.86 | Professional | None | $346.74 | $346.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $457.09 | Professional | None | $302.00 | $416.87 | $457.09 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $190.55 Typical High $288.40 | Professional | None | $28.18 | $190.55 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $537.03 | Professional | None | $302.00 | $457.09 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $467.74 | Professional | None | $251.19 | $398.11 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $831.76 | Professional | None | $295.12 | $467.74 | $831.76 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $524.81 | Professional | None | $213.80 | $338.84 | $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 $169.82 Median $169.82 Typical High $257.04 | Professional | 52 · Reduced service | $169.82 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $102.33 | Professional | 53 · Discontinued | $69.18 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $389.05 | Professional | 54 · Surgery only | $257.04 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $363.08 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 5.5 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
$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.