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 $169.82 Median $275.42 Typical High $4,570.88 | Facility | None | $169.82 | $275.42 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $275.42 | Professional | None | $138.04 | $194.98 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $323.59 | Professional | None | $151.36 | $229.09 | $323.59 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $199.53 | Professional | None | $125.89 | $158.49 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,818.38 | Facility | None | $1,479.11 | $1,949.84 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $323.59 | Professional | None | $151.36 | $245.47 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $398.11 | Professional | None | $154.88 | $245.47 | $398.11 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $331.13 | Professional | None | $117.49 | $194.98 | $331.13 |
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 $81.28 Median $89.13 Typical High $134.90 | Professional | 52 · Reduced service | $81.28 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $35.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $131.83 Typical High $204.17 | Professional | 54 · Surgery only | $123.03 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $26.30 Typical High $40.74 | Professional | 55 · Aftercare only | $24.55 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $123.03 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $114.82 | $123.03 | $190.55 |
Where Utah sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 48th of 51
$174
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.