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 $1,621.81 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,621.81 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,621.81 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,621.81 | $1,819.70 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $831.76 Typical High $1,174.90 | Professional | None | $109.65 | $831.76 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,398.83 | Professional | None | $1,737.80 | $2,041.74 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,148.15 | $2,041.74 | $4,265.80 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,479.11 | $2,884.03 |
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 $741.31 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,148.15 |
Where Utah sits
The same service costs 7.4 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
$933
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.