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 $281.84 Median $4,570.88 Typical High $9,120.11 | Facility | None | $281.84 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $323.59 | Professional | None | $204.17 | $281.84 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $4,570.88 | Facility | None | $1,698.24 | $1,778.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $389.05 | Professional | None | $245.47 | $251.19 | $389.05 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $190.55 | Professional | None | $107.15 | $141.25 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | None | $269.15 | $302.00 | $354.81 |
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 $229.09 Median $346.74 Typical High $407.38 | Professional | None | $229.09 | $346.74 | $407.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $457.09 | Professional | None | $158.49 | $295.12 | $457.09 |
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 $186.21 Median $213.80 Typical High $380.19 | Professional | None | $186.21 | $213.80 | $380.19 |
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 $109.65 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $109.65 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $162.18 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $151.36 | $194.98 | $194.98 |
Where Utah sits
The same service costs 5.6 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
$155
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.