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 $323.59 Median $4,570.88 Typical High $9,120.11 | Facility | None | $323.59 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $371.54 | Professional | None | $251.19 | $323.59 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,737.80 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $407.38 | Professional | None | $288.40 | $295.12 | $407.38 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $194.98 | Professional | None | $125.89 | $162.18 | $194.98 |
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 $316.23 Median $346.74 Typical High $416.87 | Professional | None | $316.23 | $346.74 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $467.74 | Professional | None | $263.03 | $398.11 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $537.03 | Professional | None | $181.97 | $331.13 | $537.03 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $436.52 | Professional | None | $218.78 | $245.47 | $436.52 |
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 $125.89 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $229.09 | $229.09 |
Where Utah sits
The same service costs 6.0 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
$166
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.