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 $1,412.54 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,412.54 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,412.54 | $1,412.54 |
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 $1,230.27 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,318.26 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $707.95 Typical High $912.01 | Professional | None | $54.95 | $707.95 | $912.01 |
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 $1,348.96 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,513.56 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,737.80 | $2,041.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $3,467.37 | Professional | None | $794.33 | $1,445.44 | $3,467.37 |
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 $977.24 Median $1,122.02 Typical High $1,995.26 | Professional | None | $977.24 | $1,122.02 | $1,995.26 |
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 $549.54 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $1,000.00 | $1,000.00 |
Where Utah sits
The same service costs 6.2 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· 50th of 51
$724
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.