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 $117.49 Median $2,951.21 Typical High $4,570.88 | Facility | None | $117.49 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $199.53 | Professional | None | $114.82 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $154.88 | Facility | None | $147.91 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $309.03 | Professional | None | $123.03 | $204.17 | $309.03 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $165.96 | Professional | None | $100.00 | $128.82 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $380.19 Median $478.63 Typical High $691.83 | Facility | None | $380.19 | $478.63 | $691.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $288.40 | Professional | None | $141.25 | $223.87 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $331.13 | Professional | None | $134.90 | $213.80 | $331.13 |
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 $104.71 Median $177.83 Typical High $316.23 | Professional | None | $104.71 | $177.83 | $316.23 |
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 $58.88 Median $85.11 Typical High $100.00 | Professional | 52 · Reduced service | $58.88 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $39.81 | Professional | 53 · Discontinued | $23.44 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $128.82 Typical High $151.36 | Professional | 54 · Surgery only | $89.13 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $30.20 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $83.18 | $120.23 | $141.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $575.44 Median $724.44 Typical High $1,047.13 | Facility | 50 · Both sides | $575.44 | $724.44 | $1,047.13 |
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· 48th of 51
$148
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.