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 $281.84 Median $2,951.21 Typical High $4,570.88 | Facility | None | $281.84 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $389.05 | Professional | None | $281.84 | $338.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $309.03 Typical High $316.23 | Facility | None | $295.12 | $309.03 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $489.78 | Professional | None | $257.04 | $346.74 | $489.78 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $269.15 Typical High $380.19 | Professional | None | $26.92 | $269.15 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $524.81 | Professional | None | $281.84 | $446.68 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $660.69 | Professional | None | $239.88 | $354.81 | $660.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $741.31 | Professional | None | $245.47 | $436.52 | $741.31 |
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 $213.80 Median $309.03 Typical High $501.19 | Professional | None | $213.80 | $309.03 | $501.19 |
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 $141.25 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.18 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $275.42 |
Where Utah sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 42nd of 51
$282
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.