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 $269.15 Median $295.12 Typical High $416.87 | Professional | None | $269.15 | $295.12 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $229.09 Typical High $234.42 | Facility | None | $218.78 | $229.09 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $489.78 | Professional | None | $269.15 | $346.74 | $489.78 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $199.53 Typical High $288.40 | Professional | None | $26.30 | $199.53 | $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 $251.19 Median $363.08 Typical High $489.78 | Professional | None | $251.19 | $363.08 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $524.81 | Professional | None | $213.80 | $354.81 | $524.81 |
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 $309.03 Typical High $501.19 | Professional | None | $208.93 | $309.03 | $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 $134.90 Median $147.91 Typical High $208.93 | Professional | 52 · Reduced service | $134.90 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $83.18 | Professional | 53 · Discontinued | $53.70 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $204.17 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $63.10 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $41.69 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $295.12 |
Where Utah sits
The same service costs 3.7 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· 50th of 51
$245
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.