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 $1,778.28 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,778.28 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,778.28 | $1,778.28 |
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 $1,548.82 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,659.59 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $912.01 Typical High $1,174.90 | Professional | None | $109.65 | $912.01 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,949.84 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,445.44 | $2,290.87 | $2,691.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,905.46 | $2,691.53 |
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 $1,202.26 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,380.38 | $2,454.71 |
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 $691.83 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,047.13 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $208.93 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $1,230.27 | $1,230.27 |
Where Utah sits
The same service costs 5.4 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
$933
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.