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 $257.04 Median $2,951.21 Typical High $4,570.88 | Facility | None | $257.04 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $346.74 | Professional | None | $194.98 | $257.04 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $162.18 | Facility | None | $154.88 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $288.40 | Professional | None | $218.78 | $239.88 | $288.40 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $141.25 Typical High $213.80 | Professional | None | $26.92 | $141.25 | $213.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Facility | None | $371.54 | $489.78 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $331.13 | Professional | None | $269.15 | $302.00 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $398.11 | Professional | None | $223.87 | $338.84 | $398.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $478.63 | Professional | None | $181.97 | $338.84 | $478.63 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $346.74 | Professional | None | $177.83 | $208.93 | $346.74 |
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 $117.49 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 54 · Surgery only | $177.83 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $181.97 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $165.96 | $181.97 | $199.53 |
Where Utah sits
The same service costs 5.1 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
$170
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.