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 $363.08 Median $2,884.03 Typical High $4,786.30 | Facility | None | $363.08 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $524.81 | Professional | None | $302.00 | $363.08 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $295.12 | Facility | None | $275.42 | $288.40 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $467.74 | Professional | None | $316.23 | $426.58 | $467.74 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $218.78 Typical High $316.23 | Professional | None | $28.18 | $218.78 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $562.34 | Professional | None | $316.23 | $478.63 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $467.74 | Professional | None | $269.15 | $398.11 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $912.01 | Professional | None | $281.84 | $489.78 | $912.01 |
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 $234.42 Median $354.81 Typical High $549.54 | Professional | None | $234.42 | $354.81 | $549.54 |
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 $181.97 Median $181.97 Typical High $263.03 | Professional | 52 · Reduced service | $181.97 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | 53 · Discontinued | $72.44 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $398.11 | Professional | 54 · Surgery only | $269.15 | $269.15 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $371.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 4.3 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
$245
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.