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 $9,120.11 | Facility | None | $891.25 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,174.90 | Professional | None | $891.25 | $891.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,548.82 | Professional | None | $933.25 | $933.25 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $467.74 Typical High $676.08 | Professional | None | $56.23 | $467.74 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,332.54 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,230.27 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,659.59 | Professional | None | $549.54 | $1,174.90 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,659.59 | Professional | None | $758.58 | $851.14 | $1,659.59 |
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 $436.52 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,197.01 Typical High $26,302.68 | Facility | 50 · Both sides | $13,803.84 | $18,197.01 | $26,302.68 |
Where Utah sits
The same service costs 7.4 times more in Oklahoma 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
$525
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.