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 $524.81 Median $4,570.88 Typical High $9,120.11 | Facility | None | $524.81 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $537.03 | Professional | None | $398.11 | $524.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $676.08 | Professional | None | $478.63 | $489.78 | $676.08 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $380.19 | Professional | None | $204.17 | $288.40 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $10,471.29 | Facility | None | $5,754.40 | $7,244.36 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $676.08 | Professional | None | $524.81 | $575.44 | $676.08 |
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 $436.52 Median $724.44 Typical High $851.14 | Professional | None | $436.52 | $724.44 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $1,479.11 | Professional | None | $309.03 | $588.84 | $1,479.11 |
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 $363.08 Median $416.87 Typical High $758.58 | Professional | None | $363.08 | $416.87 | $758.58 |
7 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 $208.93 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $371.54 | $371.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $10,964.78 Typical High $15,848.93 | Facility | 50 · Both sides | $8,709.64 | $10,964.78 | $15,848.93 |
Where Utah sits
The same service costs 5.6 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
$295
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.