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 $891.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $891.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $891.25 | Professional | None | $645.65 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $1,995.26 | Facility | None | $1,862.09 | $1,949.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $912.01 | Professional | None | $741.31 | $758.58 | $912.01 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $346.74 Typical High $501.19 | Professional | None | $56.23 | $346.74 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,772.37 | Facility | None | $5,128.61 | $6,760.83 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $954.99 | Professional | None | $812.83 | $870.96 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,258.93 | Professional | None | $691.83 | $1,071.52 | $1,258.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,659.59 | Professional | None | $562.34 | $1,000.00 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $7,244.36 Typical High $8,317.64 | Facility | None | $1,288.25 | $7,244.36 | $8,317.64 |
United Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,096.48 | Professional | None | $549.54 | $645.65 | $1,096.48 |
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 $363.08 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $616.60 | $616.60 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,762.47 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 7.4 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
$372
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.