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 $575.44 Median $3,162.28 Typical High $6,025.60 | Facility | None | $575.44 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $575.44 | Professional | None | $436.52 | $575.44 | $575.44 |
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 $501.19 Median $537.03 Typical High $724.44 | Professional | None | $501.19 | $537.03 | $724.44 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $416.87 | Professional | None | $204.17 | $302.00 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $707.95 | Professional | None | $549.54 | $630.96 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $851.14 | Professional | None | $457.09 | $724.44 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $380.19 Median $616.60 Typical High $891.25 | Professional | None | $380.19 | $616.60 | $891.25 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $831.76 | Professional | None | $389.05 | $436.52 | $831.76 |
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 $218.78 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $66.07 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $309.03 | $407.38 | $407.38 |
Where Utah sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 51st of 51
$316
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.