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 $1,412.54 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,412.54 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,412.54 | $1,513.56 |
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 $1,258.93 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,318.26 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $758.58 Typical High $977.24 | Professional | None | $83.18 | $758.58 | $977.24 |
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 $1,380.38 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,584.89 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,862.09 | $2,187.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,513.56 Typical High $2,238.72 | Professional | None | $794.33 | $1,513.56 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,995.26 | Professional | None | $954.99 | $1,096.48 | $1,995.26 |
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 $562.34 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $977.24 | $977.24 |
Where Utah sits
The same service costs 5.2 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
$776
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.