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 $389.05 Median $4,570.88 Typical High $8,912.51 | Facility | None | $389.05 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $446.68 | Professional | None | $281.84 | $389.05 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $4,570.88 | Facility | None | $3,467.37 | $3,630.78 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $489.78 | Professional | None | $338.84 | $363.08 | $489.78 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $263.03 | Professional | None | $151.36 | $199.53 | $263.03 |
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 $371.54 Median $416.87 Typical High $489.78 | Professional | None | $371.54 | $416.87 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,570.88 | Facility | None | $3,981.07 | $3,981.07 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $549.54 | Professional | None | $316.23 | $467.74 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $660.69 | Professional | None | $213.80 | $389.05 | $660.69 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $7,079.46 | Facility | None | $1,000.00 | $2,884.03 | $7,079.46 |
United Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $524.81 | Professional | None | $263.03 | $295.12 | $524.81 |
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 $147.91 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $223.87 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $29.51 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $208.93 | $275.42 | $275.42 |
Where Utah sits
The same service costs 5.5 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.