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 $1,698.24 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,698.24 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
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 $1,513.56 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,584.89 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $870.96 Typical High $1,122.02 | Professional | None | $109.65 | $870.96 | $1,122.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,819.70 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,380.38 | $2,187.76 | $2,570.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,148.15 | $1,995.26 | $3,801.89 |
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 $1,174.90 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,348.96 | $2,398.83 |
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 $676.08 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,202.26 | $1,202.26 |
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
$891
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.