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 $158.49 Median $2,951.21 Typical High $4,570.88 | Facility | None | $158.49 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $162.18 | Professional | None | $117.49 | $158.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $104.71 Typical High $107.15 | Facility | None | $100.00 | $104.71 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $165.96 | Professional | None | $131.83 | $134.90 | $165.96 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $83.18 Typical High $125.89 | Professional | None | $26.30 | $83.18 | $125.89 |
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 $158.49 Median $186.21 Typical High $234.42 | Professional | None | $158.49 | $186.21 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $239.88 | Professional | None | $131.83 | $204.17 | $239.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $275.42 | Professional | None | $100.00 | $190.55 | $275.42 |
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 $102.33 Median $120.23 Typical High $194.98 | Professional | None | $102.33 | $120.23 | $194.98 |
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 $69.18 Median $79.43 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $31.62 Typical High $32.36 | Professional | 53 · Discontinued | $27.54 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $123.03 | Professional | 54 · Surgery only | $104.71 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.85 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.80 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $112.20 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $97.72 | $112.20 | $114.82 |
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
$97.72
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.