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 $501.19 Median $3,162.28 Typical High $4,570.88 | Facility | None | $501.19 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $562.34 | Professional | None | $467.74 | $501.19 | $562.34 |
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 $489.78 Median $489.78 Typical High $758.58 | Professional | None | $489.78 | $489.78 | $758.58 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $288.40 Typical High $380.19 | Professional | None | $26.92 | $288.40 | $380.19 |
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 $575.44 Median $630.96 Typical High $741.31 | Professional | None | $575.44 | $630.96 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $891.25 | Professional | None | $478.63 | $758.58 | $891.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $323.59 Median $630.96 Typical High $1,380.38 | Professional | None | $323.59 | $630.96 | $1,380.38 |
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 $380.19 Median $446.68 Typical High $812.83 | Professional | None | $380.19 | $446.68 | $812.83 |
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 $234.42 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $371.54 |
Where Utah sits
The same service costs 6.2 times more in Alaska 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
$309
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.