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 $524.81 Median $3,162.28 Typical High $8,709.64 | Facility | None | $524.81 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $724.44 | Professional | None | $407.38 | $524.81 | $724.44 |
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 $467.74 Median $588.84 Typical High $645.65 | Professional | None | $467.74 | $588.84 | $645.65 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $281.84 Typical High $446.68 | Professional | None | $56.23 | $281.84 | $446.68 |
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 $467.74 Median $645.65 Typical High $758.58 | Professional | None | $467.74 | $645.65 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $660.69 | Professional | None | $389.05 | $562.34 | $660.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,122.02 | Professional | None | $446.68 | $691.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $758.58 | Professional | None | $338.84 | $489.78 | $758.58 |
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 $263.03 Median $263.03 Typical High $363.08 | Professional | 52 · Reduced service | $263.03 | $263.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | 53 · Discontinued | $104.71 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | 54 · Surgery only | $398.11 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $109.65 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $512.86 |
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 4.8 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
$324
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.