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 $194.98 Median $2,951.21 Typical High $4,570.88 | Facility | None | $194.98 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $213.80 | Professional | None | $141.25 | $194.98 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $141.25 | Facility | None | $134.90 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | None | $162.18 | $177.83 | $204.17 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $97.72 Typical High $177.83 | Professional | None | $26.92 | $97.72 | $177.83 |
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 $186.21 Median $218.78 Typical High $251.19 | Professional | None | $186.21 | $218.78 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $275.42 | Professional | None | $154.88 | $239.88 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $380.19 | Professional | None | $134.90 | $245.47 | $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 $125.89 Median $147.91 Typical High $239.88 | Professional | None | $125.89 | $147.91 | $239.88 |
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 $83.18 Median $97.72 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $42.66 | Professional | 53 · Discontinued | $33.11 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $125.89 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $151.36 |
Where Utah sits
The same service costs 4.9 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
$123
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.