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 $457.09 Median $2,884.03 Typical High $4,786.30 | Facility | None | $457.09 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $602.56 | Professional | None | $398.11 | $467.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $660.69 | Professional | None | $416.87 | $512.86 | $660.69 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $338.84 Typical High $446.68 | Professional | None | $26.92 | $338.84 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,332.54 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $660.69 | Professional | None | $416.87 | $562.34 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $831.76 | Professional | None | $346.74 | $549.54 | $831.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $1,023.29 | Professional | None | $363.08 | $575.44 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $707.95 | Professional | None | $331.13 | $446.68 | $707.95 |
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 $208.93 Median $229.09 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $309.03 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $416.87 |
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· 50th of 51
$355
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.