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 $398.11 Median $2,884.03 Typical High $4,786.30 | Facility | None | $398.11 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $501.19 | Professional | None | $309.03 | $398.11 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,737.80 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $630.96 | Professional | None | $363.08 | $436.52 | $630.96 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $263.03 Typical High $354.81 | Professional | None | $26.92 | $263.03 | $354.81 |
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 $363.08 Median $467.74 Typical High $616.60 | Professional | None | $363.08 | $467.74 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $758.58 | Professional | None | $281.84 | $512.86 | $758.58 |
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 $295.12 Median $380.19 Typical High $645.65 | Professional | None | $295.12 | $380.19 | $645.65 |
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 $177.83 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $177.83 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $100.00 | Professional | 53 · Discontinued | $70.79 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $269.15 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $50.12 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $346.74 |
Where Utah sits
The same service costs 4.9 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
$302
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.