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 $112.20 Median $165.96 Typical High $4,570.88 | Facility | None | $112.20 | $165.96 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $165.96 | Professional | None | $112.20 | $141.25 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $138.04 Typical High $141.25 | Facility | None | $128.82 | $138.04 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $251.19 | Professional | None | $117.49 | $169.82 | $251.19 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | None | $95.50 | $114.82 | $141.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $234.42 | Professional | None | $131.83 | $190.55 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $302.00 | Professional | None | $77.62 | $190.55 | $302.00 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $257.04 | Professional | None | $97.72 | $147.91 | $257.04 |
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 $56.23 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $56.23 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $85.11 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $16.98 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $100.00 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $79.43 | $100.00 | $117.49 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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
$138
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.