How much rates vary
Facilitymedian $4,169 · 10th to 90th $447 to $10,233Professionalmedian $1,349 · 10th to 90th $380 to $2,692
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 $446.68 Median $3,162.28 Typical High $8,511.38 | Facility | None | $446.68 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $1,621.81 Typical High $1,698.24 | Professional | None | $446.68 | $1,621.81 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,862.09 | $1,905.46 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,348.96 Typical High $2,570.40 | Professional | None | $398.11 | $1,348.96 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $1,479.11 Typical High $2,041.74 | Professional | None | $147.91 | $1,479.11 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $6,456.54 Typical High $9,332.54 | Facility | None | $5,248.07 | $6,456.54 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $446.68 Median $1,737.80 Typical High $2,630.27 | Professional | None | $446.68 | $1,737.80 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $218.78 Median $1,778.28 Typical High $3,981.07 | Professional | None | $218.78 | $1,778.28 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $11,481.54 | Facility | None | $1,288.25 | $4,168.69 | $11,481.54 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,148.15 Typical High $3,019.95 | Professional | None | $338.84 | $1,148.15 | $3,019.95 |
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 $223.87 Median $489.78 Typical High $794.33 | Professional | 52 · Reduced service | $223.87 | $489.78 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $199.53 Typical High $323.59 | Professional | 53 · Discontinued | $89.13 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $741.31 Typical High $1,202.26 | Professional | 54 · Surgery only | $331.13 | $741.31 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $147.91 Typical High $239.88 | Professional | 55 · Aftercare only | $67.61 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $100.00 Typical High $162.18 | Professional | 56 · Pre-op care only | $44.67 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $691.83 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $309.03 | $691.83 | $1,122.02 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $9,772.37 Typical High $14,125.38 | Facility | 50 · Both sides | $7,762.47 | $9,772.37 | $14,125.38 |
Where Utah sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 17th of 51
$1,622
AK $3,548NE $617
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.