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 $691.83 Median $3,162.28 Typical High $8,511.38 | Facility | None | $691.83 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,122.02 | Professional | None | $416.87 | $691.83 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $269.15 Typical High $275.42 | Facility | None | $251.19 | $269.15 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $891.25 | Professional | None | $398.11 | $602.56 | $891.25 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $457.09 Typical High $1,148.15 | Professional | None | $40.74 | $457.09 | $1,148.15 |
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 $354.81 Median $537.03 Typical High $1,348.96 | Professional | None | $354.81 | $537.03 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $741.31 | Professional | None | $331.13 | $537.03 | $741.31 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $912.01 | Professional | None | $281.84 | $562.34 | $912.01 |
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 $239.88 Median $346.74 Typical High $489.78 | Professional | 52 · Reduced service | $239.88 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $95.50 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $524.81 Typical High $724.44 | Professional | 54 · Surgery only | $363.08 | $524.81 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $104.71 Typical High $144.54 | Professional | 55 · Aftercare only | $72.44 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $69.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $47.86 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $489.78 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $338.84 | $489.78 | $676.08 |
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 4.1 times more in Wisconsin 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· 15th of 51
$692
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.