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 $147.91 Median $2,951.21 Typical High $4,570.88 | Facility | None | $147.91 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $213.80 | Professional | None | $147.91 | $169.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $151.36 | Facility | None | $144.54 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $245.47 | Professional | None | $131.83 | $186.21 | $245.47 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $194.98 | Professional | None | $100.00 | $141.25 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,513.56 | Facility | None | $831.76 | $1,071.52 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $257.04 | Professional | None | $138.04 | $218.78 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $323.59 | Professional | None | $114.82 | $177.83 | $323.59 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $363.08 | Professional | None | $120.23 | $213.80 | $363.08 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $257.04 | Professional | None | $107.15 | $162.18 | $257.04 |
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 $74.13 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $74.13 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $109.65 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $151.36 |
Where Utah sits
The same service costs 3.5 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· 39th of 51
$151
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.