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 $323.59 Median $2,951.21 Typical High $4,570.88 | Facility | None | $323.59 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $354.81 | Professional | None | $229.09 | $323.59 | $354.81 |
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 $275.42 Median $302.00 Typical High $338.84 | Professional | None | $275.42 | $302.00 | $338.84 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $158.49 Typical High $239.88 | Professional | None | $54.95 | $158.49 | $239.88 |
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 $295.12 Median $346.74 Typical High $398.11 | Professional | None | $295.12 | $346.74 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $467.74 | Professional | None | $251.19 | $398.11 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $602.56 | Professional | None | $213.80 | $389.05 | $602.56 |
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 $208.93 Median $239.88 Typical High $398.11 | Professional | None | $208.93 | $239.88 | $398.11 |
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 $131.83 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $64.57 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $199.53 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $39.81 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $223.87 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $186.21 | $223.87 | $245.47 |
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
$186
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.