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 $1,659.59 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,659.59 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $6,165.95 | Facility | None | $5,888.44 | $6,025.60 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,548.82 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $776.25 Typical High $1,047.13 | Professional | None | $85.11 | $776.25 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,218.10 Median $21,379.62 Typical High $30,902.95 | Facility | None | $16,218.10 | $21,379.62 | $30,902.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,778.28 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,348.96 | $2,089.30 | $2,454.71 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,778.28 Typical High $3,311.31 | Professional | None | $977.24 | $1,778.28 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $11,481.54 Typical High $24,547.09 | Facility | None | $2,691.53 | $11,481.54 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,288.25 | $2,344.23 |
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 $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $977.24 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $912.01 | $1,174.90 | $1,174.90 |
Where Utah sits
The same service costs 25.7 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
$794
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.