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 $3,162.28 Median $5,011.87 Typical High $6,025.60 | Facility | None | $3,162.28 | $5,011.87 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,365.16 | $5,011.87 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,918.31 | Professional | None | $4,897.79 | $4,897.79 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $2,570.40 Typical High $3,548.13 | Professional | None | $295.12 | $2,570.40 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $6,918.31 | Professional | None | $5,248.07 | $5,888.44 | $6,918.31 |
Select Health Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $4,466.84 Median $6,918.31 Typical High $8,128.31 | Professional | None | $4,466.84 | $6,918.31 | $8,128.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $3,388.44 Median $6,025.60 Typical High $10,471.29 | Professional | None | $3,388.44 | $6,025.60 | $10,471.29 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $4,365.16 Typical High $7,762.47 | Professional | None | $3,715.35 | $4,365.16 | $7,762.47 |
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 $2,187.76 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,187.76 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $870.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,235.94 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $645.65 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,019.95 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,019.95 | $3,467.37 | $3,467.37 |
Where Utah sits
The same service costs 21.9 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
$2,692
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.