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 $691.83 Median $4,570.88 Typical High $8,912.51 | Facility | None | $691.83 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | None | $512.86 | $691.83 | $691.83 |
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 $562.34 Median $616.60 Typical High $831.76 | Professional | None | $562.34 | $616.60 | $831.76 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $316.23 Typical High $416.87 | Professional | None | $54.95 | $316.23 | $416.87 |
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 $616.60 Median $707.95 Typical High $812.83 | Professional | None | $616.60 | $707.95 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $912.01 | Professional | None | $524.81 | $776.25 | $912.01 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,819.70 | Professional | None | $371.54 | $660.69 | $1,819.70 |
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 $446.68 Median $512.86 Typical High $912.01 | Professional | None | $446.68 | $512.86 | $912.01 |
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 $257.04 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $102.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $75.86 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $354.81 | $478.63 | $478.63 |
Where Utah sits
The same service costs 6.3 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
$331
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.