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 $204.17 Median $2,951.21 Typical High $4,570.88 | Facility | None | $204.17 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $275.42 | Professional | None | $165.96 | $218.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $794.33 | Facility | None | $758.58 | $776.25 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $309.03 | Professional | None | $186.21 | $245.47 | $309.03 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $194.98 | Professional | None | $125.89 | $158.49 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $316.23 | Professional | None | $199.53 | $269.15 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $380.19 | Professional | None | $165.96 | $251.19 | $380.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $416.87 | Professional | None | $162.18 | $263.03 | $416.87 |
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 $147.91 Median $208.93 Typical High $331.13 | Professional | None | $147.91 | $208.93 | $331.13 |
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 $97.72 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $97.72 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $39.81 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $158.49 Typical High $204.17 | Professional | 54 · Surgery only | $147.91 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $29.51 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $147.91 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $138.04 | $147.91 | $190.55 |
Where Utah sits
The same service costs 4.2 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· 49th of 51
$174
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.