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 $724.44 Median $4,570.88 Typical High $8,912.51 | Facility | None | $724.44 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
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 $602.56 Median $602.56 Typical High $758.58 | Professional | None | $602.56 | $602.56 | $758.58 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $281.84 Typical High $426.58 | Professional | None | $56.23 | $281.84 | $426.58 |
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 $691.83 Median $741.31 Typical High $812.83 | Professional | None | $691.83 | $741.31 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,096.48 | Professional | None | $588.84 | $933.25 | $1,096.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,380.38 | Professional | None | $489.78 | $912.01 | $1,380.38 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $933.25 | Professional | None | $446.68 | $537.03 | $933.25 |
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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $501.19 |
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 7.9 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
$302
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.