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 $144.54 Median $2,951.21 Typical High $4,570.88 | Facility | None | $144.54 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $194.98 | Professional | None | $114.82 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $120.23 Typical High $123.03 | Facility | None | $114.82 | $120.23 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $213.80 | Professional | None | $131.83 | $169.82 | $213.80 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $128.82 | Professional | None | $75.86 | $97.72 | $128.82 |
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 $141.25 Median $181.97 Typical High $213.80 | Professional | None | $141.25 | $181.97 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $263.03 | Professional | None | $117.49 | $181.97 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $295.12 | Professional | None | $109.65 | $186.21 | $295.12 |
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 $104.71 Median $144.54 Typical High $234.42 | Professional | None | $104.71 | $144.54 | $234.42 |
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 $67.61 Median $74.13 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $26.92 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $109.65 Typical High $147.91 | Professional | 54 · Surgery only | $102.33 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.88 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $102.33 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $95.50 | $102.33 | $138.04 |
Where Utah sits
The same service costs 4.0 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· 48th of 51
$115
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.