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 $707.95 Median $3,162.28 Typical High $8,709.64 | Facility | None | $707.95 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $933.25 | Professional | None | $660.69 | $707.95 | $933.25 |
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 $630.96 Median $758.58 Typical High $851.14 | Professional | None | $630.96 | $758.58 | $851.14 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $371.54 Typical High $562.34 | Professional | None | $56.23 | $371.54 | $562.34 |
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 $616.60 Median $831.76 Typical High $977.24 | Professional | None | $616.60 | $831.76 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $954.99 | Professional | None | $524.81 | $812.83 | $954.99 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,548.82 | Professional | None | $575.44 | $912.01 | $1,548.82 |
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 $457.09 Median $616.60 Typical High $977.24 | Professional | None | $457.09 | $616.60 | $977.24 |
6 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 $331.13 Median $354.81 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $354.81 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $186.21 | Professional | 53 · Discontinued | $131.83 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $691.83 | Professional | 54 · Surgery only | $501.19 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $93.33 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $645.65 |
Where Utah sits
The same service costs 5.8 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
$427
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.