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 $302.00 Median $2,884.03 Typical High $4,786.30 | Facility | None | $302.00 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $398.11 | Professional | None | $234.42 | $302.00 | $398.11 |
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 $281.84 Median $346.74 Typical High $436.52 | Professional | None | $281.84 | $346.74 | $436.52 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $190.55 Typical High $257.04 | Professional | None | $26.30 | $190.55 | $257.04 |
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 $288.40 Median $380.19 Typical High $446.68 | Professional | None | $288.40 | $380.19 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $537.03 | Professional | None | $239.88 | $363.08 | $537.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $602.56 | Professional | None | $229.09 | $389.05 | $602.56 |
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 $218.78 Median $295.12 Typical High $478.63 | Professional | None | $218.78 | $295.12 | $478.63 |
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 $141.25 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $141.25 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $208.93 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $275.42 |
Where Utah sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 51st of 51
$219
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.