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 $758.58 Median $4,570.88 Typical High $8,912.51 | Facility | None | $758.58 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $812.83 | Professional | None | $630.96 | $758.58 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $1,737.80 | Facility | None | $1,621.81 | $1,698.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,023.29 | Professional | None | $691.83 | $691.83 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $436.52 Typical High $575.44 | Professional | None | $54.95 | $436.52 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,466.84 Median $5,623.41 Typical High $8,128.31 | Facility | None | $4,466.84 | $5,623.41 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,047.13 | Professional | None | $794.33 | $891.25 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,288.25 | Professional | None | $660.69 | $1,096.48 | $1,288.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $467.74 Median $912.01 Typical High $1,584.89 | Professional | None | $467.74 | $912.01 | $1,584.89 |
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 $537.03 Median $630.96 Typical High $1,148.15 | Professional | None | $537.03 | $630.96 | $1,148.15 |
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 $316.23 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $524.81 |
Where Utah sits
The same service costs 5.6 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
$468
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.