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 $295.12 Median $2,884.03 Typical High $4,786.30 | Facility | None | $295.12 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $407.38 | Professional | None | $275.42 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $363.08 | Facility | None | $338.84 | $354.81 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $489.78 | Professional | None | $263.03 | $354.81 | $489.78 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $213.80 Typical High $288.40 | Professional | None | $26.92 | $213.80 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,513.56 | Facility | None | $831.76 | $1,071.52 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $489.78 | Professional | None | $257.04 | $371.54 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $537.03 | Professional | None | $223.87 | $371.54 | $537.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $501.19 | Professional | None | $208.93 | $302.00 | $501.19 |
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 $138.04 Median $144.54 Typical High $199.53 | Professional | 52 · Reduced service | $138.04 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $81.28 | Professional | 53 · Discontinued | $54.95 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $302.00 | Professional | 54 · Surgery only | $204.17 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $40.74 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $204.17 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $190.55 | $204.17 | $281.84 |
Where Utah sits
The same service costs 3.7 times more in Wisconsin 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
$240
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.