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 $831.76 Median $4,570.88 Typical High $9,120.11 | Facility | None | $831.76 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $831.76 | Professional | None | $630.96 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,047.13 | Facility | None | $1,000.00 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | None | $707.95 | $707.95 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $316.23 Typical High $537.03 | Professional | None | $54.95 | $316.23 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,511.89 | $3,311.31 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $933.25 | Professional | None | $794.33 | $851.14 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,230.27 | Professional | None | $676.08 | $1,047.13 | $1,230.27 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,584.89 | Professional | None | $562.34 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $1,071.52 | Professional | None | $524.81 | $616.60 | $1,071.52 |
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 $354.81 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $588.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $4,897.79 Typical High $7,244.36 | Facility | 50 · Both sides | $3,801.89 | $4,897.79 | $7,244.36 |
Where Utah sits
The same service costs 7.2 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
$355
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.