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 $501.19 Median $4,570.88 Typical High $8,912.51 | Facility | None | $501.19 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $676.08 | Professional | None | $489.78 | $501.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,819.70 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $977.24 | Professional | None | $588.84 | $602.56 | $977.24 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $354.81 Typical High $512.86 | Professional | None | $54.95 | $354.81 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $11,481.54 | Facility | None | $5,888.44 | $7,943.28 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $912.01 | Professional | None | $660.69 | $776.25 | $912.01 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $380.19 Median $776.25 Typical High $1,148.15 | Professional | None | $380.19 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,071.52 | Professional | None | $478.63 | $575.44 | $1,071.52 |
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 $245.47 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $346.74 | $363.08 |
Where Utah sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 51st of 51
$398
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.