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 $2,951.21 Typical High $4,570.88 | Facility | None | $169.82 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $263.03 | Professional | None | $134.90 | $204.17 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $204.17 | Facility | None | $190.55 | $199.53 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $363.08 | Professional | None | $151.36 | $229.09 | $363.08 |
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 $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $338.84 | Professional | None | $154.88 | $269.15 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $389.05 | Professional | None | $151.36 | $251.19 | $389.05 |
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 $123.03 Median $204.17 Typical High $371.54 | Professional | None | $123.03 | $204.17 | $371.54 |
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 $83.18 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $83.18 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $33.88 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $125.89 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $141.25 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $117.49 | $141.25 | $186.21 |
Where Utah sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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
$178
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.