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 $223.87 Median $2,951.21 Typical High $4,570.88 | Facility | None | $223.87 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $338.84 | Professional | None | $186.21 | $275.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $251.19 | Facility | None | $234.42 | $245.47 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $446.68 | Professional | None | $199.53 | $295.12 | $446.68 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $162.18 Typical High $223.87 | Professional | None | $26.30 | $162.18 | $223.87 |
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 $208.93 Median $316.23 Typical High $407.38 | Professional | None | $208.93 | $316.23 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $489.78 | Professional | None | $181.97 | $331.13 | $489.78 |
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 $165.96 Median $257.04 Typical High $446.68 | Professional | None | $165.96 | $257.04 | $446.68 |
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 $112.20 Median $125.89 Typical High $169.82 | Professional | 52 · Reduced service | $112.20 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $67.61 | Professional | 53 · Discontinued | $45.71 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $186.21 Typical High $257.04 | Professional | 54 · Surgery only | $169.82 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $33.88 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $173.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $158.49 | $173.78 | $239.88 |
Where Utah sits
The same service costs 4.3 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
$200
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.