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 $354.81 Median $478.63 Typical High $4,570.88 | Facility | None | $354.81 | $478.63 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $489.78 | Professional | None | $354.81 | $446.68 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $489.78 | Facility | None | $457.09 | $478.63 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $645.65 | Professional | None | $316.23 | $426.58 | $645.65 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $371.54 Typical High $501.19 | Professional | None | $26.92 | $371.54 | $501.19 |
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 $389.05 Median $588.84 Typical High $691.83 | Professional | None | $389.05 | $588.84 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $891.25 | Professional | None | $323.59 | $524.81 | $891.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $912.01 | Professional | None | $338.84 | $575.44 | $912.01 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $660.69 | Professional | None | $269.15 | $389.05 | $660.69 |
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 $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $177.83 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $269.15 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $338.84 |
Where Utah sits
The same service costs 4.3 times more in Alaska 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· 38th of 51
$380
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.