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 $1,348.96 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,348.96 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,348.96 | $1,348.96 |
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 $1,318.26 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,445.44 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $707.95 Typical High $977.24 | Professional | None | $85.11 | $707.95 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,659.59 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,290.87 | Professional | None | $954.99 | $1,698.24 | $2,290.87 |
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 $1,047.13 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,230.27 | $2,344.23 |
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 $602.56 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $933.25 |
Where Utah sits
The same service costs 6.8 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
$794
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.