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 $524.81 Median $4,570.88 Typical High $8,912.51 | Facility | None | $524.81 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | None | $446.68 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,466.84 | Facility | None | $4,168.69 | $4,365.16 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $549.54 | Professional | None | $436.52 | $436.52 | $549.54 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $229.09 Typical High $331.13 | Professional | None | $28.18 | $229.09 | $331.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,791.08 Typical High $21,379.62 | Facility | None | $11,481.54 | $14,791.08 | $21,379.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $602.56 | Professional | None | $501.19 | $537.03 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $812.83 | Professional | None | $426.58 | $691.83 | $812.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $1,380.38 | Professional | None | $331.13 | $630.96 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $691.83 | Professional | None | $331.13 | $389.05 | $691.83 |
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 $223.87 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $371.54 | $371.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,877.62 Typical High $32,359.37 | Facility | 50 · Both sides | $16,982.44 | $21,877.62 | $32,359.37 |
Where Utah sits
The same service costs 7.2 times more in Alaska than in Texas. 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
$245
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.