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 $239.88 Median $2,951.21 Typical High $4,570.88 | Facility | None | $239.88 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $446.68 | Professional | None | $204.17 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $288.40 Typical High $295.12 | Facility | None | $269.15 | $288.40 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $213.80 Typical High $288.40 | Professional | None | $26.30 | $213.80 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,445.44 | $1,862.09 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $426.58 | Professional | None | $245.47 | $363.08 | $426.58 |
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 $204.17 Median $331.13 Typical High $537.03 | Professional | None | $204.17 | $331.13 | $537.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $562.34 | Professional | None | $213.80 | $346.74 | $562.34 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $407.38 | Professional | None | $177.83 | $251.19 | $407.38 |
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 $120.23 Median $138.04 Typical High $165.96 | Professional | 52 · Reduced service | $120.23 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $66.07 | Professional | 53 · Discontinued | $47.86 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $181.97 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $33.11 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $169.82 | $190.55 | $229.09 |
Where Utah sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 41st of 51
$234
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.