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 $416.87 Median $3,162.28 Typical High $8,709.64 | Facility | None | $416.87 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $616.60 | Professional | None | $323.59 | $416.87 | $616.60 |
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 $371.54 Median $478.63 Typical High $549.54 | Professional | None | $371.54 | $478.63 | $549.54 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $213.80 Typical High $346.74 | Professional | None | $26.92 | $213.80 | $346.74 |
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 $354.81 Median $524.81 Typical High $616.60 | Professional | None | $354.81 | $524.81 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $549.54 | Professional | None | $302.00 | $478.63 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $1,122.02 | Professional | None | $354.81 | $575.44 | $1,122.02 |
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 $257.04 Median $389.05 Typical High $630.96 | Professional | None | $257.04 | $389.05 | $630.96 |
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 $208.93 Median $208.93 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $208.93 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $123.03 | Professional | 53 · Discontinued | $83.18 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | 54 · Surgery only | $309.03 | $309.03 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $61.66 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $426.58 |
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 5.9 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
$240
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.