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 $446.68 Median $2,884.03 Typical High $4,786.30 | Facility | None | $446.68 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $630.96 | Professional | None | $323.59 | $446.68 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $891.25 | Facility | None | $851.14 | $870.96 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $562.34 | Professional | None | $389.05 | $512.86 | $562.34 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $257.04 Typical High $398.11 | Professional | None | $28.18 | $257.04 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,897.79 | Facility | None | $2,570.40 | $3,311.31 | $4,897.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $676.08 | Professional | None | $398.11 | $575.44 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $575.44 | Professional | None | $331.13 | $489.78 | $575.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $954.99 | Professional | None | $389.05 | $588.84 | $954.99 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $676.08 | Professional | None | $288.40 | $436.52 | $676.08 |
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 $223.87 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $128.82 | Professional | 53 · Discontinued | $89.13 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $478.63 | Professional | 54 · Surgery only | $338.84 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $446.68 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $5,011.87 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $5,011.87 | $7,244.36 |
Where Utah sits
The same service costs 4.9 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
$288
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.