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 $204.17 Median $2,951.21 Typical High $4,570.88 | Facility | None | $204.17 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $162.18 | Facility | None | $154.88 | $158.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $223.87 | Professional | None | $173.78 | $194.98 | $223.87 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $114.82 Typical High $190.55 | Professional | None | $26.30 | $114.82 | $190.55 |
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 $194.98 Median $234.42 Typical High $275.42 | Professional | None | $194.98 | $234.42 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $323.59 | Professional | None | $162.18 | $275.42 | $323.59 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $380.19 | Professional | None | $147.91 | $263.03 | $380.19 |
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 $131.83 Median $162.18 Typical High $263.03 | Professional | None | $131.83 | $162.18 | $263.03 |
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 $91.20 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $144.54 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $128.82 | $144.54 | $165.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $741.31 Typical High $1,071.52 | Facility | 50 · Both sides | $562.34 | $741.31 | $1,071.52 |
Where Utah sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$145
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.