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 $2,951.21 Typical High $4,570.88 | Facility | None | $295.12 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $426.58 | Professional | None | $229.09 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $363.08 | Facility | None | $338.84 | $354.81 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $524.81 | Professional | None | $269.15 | $371.54 | $524.81 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $218.78 Typical High $316.23 | Professional | None | $26.92 | $218.78 | $316.23 |
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 $257.04 Median $371.54 Typical High $501.19 | Professional | None | $257.04 | $371.54 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $602.56 | Professional | None | $229.09 | $389.05 | $602.56 |
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 $223.87 Median $338.84 Typical High $602.56 | Professional | None | $223.87 | $338.84 | $602.56 |
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 $147.91 Median $162.18 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $223.87 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $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
$251
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.