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 $239.88 Median $2,884.03 Typical High $4,786.30 | Facility | None | $239.88 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $346.74 | Professional | None | $190.55 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $223.87 | Facility | None | $208.93 | $218.78 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $371.54 | Professional | None | $213.80 | $281.84 | $371.54 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $165.96 Typical High $223.87 | Professional | None | $26.30 | $165.96 | $223.87 |
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 $204.17 Median $316.23 Typical High $371.54 | Professional | None | $204.17 | $316.23 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $457.09 | Professional | None | $169.82 | $269.15 | $457.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $512.86 | Professional | None | $181.97 | $316.23 | $512.86 |
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 $165.96 Median $251.19 Typical High $407.38 | Professional | None | $165.96 | $251.19 | $407.38 |
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 $117.49 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $69.18 | Professional | 53 · Discontinued | $46.77 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $181.97 Typical High $263.03 | Professional | 54 · Surgery only | $173.78 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $169.82 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $162.18 | $169.82 | $245.47 |
Where Utah sits
The same service costs 3.6 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· 48th of 51
$186
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.