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 $138.04 Median $251.19 Typical High $4,570.88 | Facility | None | $138.04 | $251.19 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | None | $134.90 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $338.84 | Professional | None | $144.54 | $229.09 | $338.84 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $138.04 Typical High $190.55 | Professional | None | $26.30 | $138.04 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $389.05 | Facility | None | $204.17 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $338.84 | Professional | None | $151.36 | $257.04 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $407.38 | Professional | None | $162.18 | $257.04 | $407.38 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $338.84 | Professional | None | $112.20 | $190.55 | $338.84 |
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 $69.18 Median $97.72 Typical High $125.89 | Professional | 52 · Reduced service | $69.18 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $27.54 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $104.71 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $177.83 |
Where Utah sits
The same service costs 4.5 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· 47th of 51
$158
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.