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 $977.24 Median $4,570.88 Typical High $9,772.37 | Facility | None | $977.24 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
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 $851.14 Median $891.25 Typical High $1,230.27 | Professional | None | $851.14 | $891.25 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $501.19 Typical High $660.69 | Professional | None | $54.95 | $501.19 | $660.69 |
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 $933.25 Median $1,047.13 Typical High $1,230.27 | Professional | None | $933.25 | $1,047.13 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,445.44 | Professional | None | $776.25 | $1,202.26 | $1,445.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $524.81 Median $1,023.29 Typical High $2,511.89 | Professional | None | $524.81 | $1,023.29 | $2,511.89 |
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 $660.69 Median $741.31 Typical High $1,318.26 | Professional | None | $660.69 | $741.31 | $1,318.26 |
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 $380.19 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $691.83 | $691.83 |
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
$513
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.