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 $794.33 Median $4,570.88 Typical High $9,120.11 | Facility | None | $794.33 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $794.33 | Professional | None | $616.60 | $794.33 | $794.33 |
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 $707.95 Median $724.44 Typical High $1,000.00 | Professional | None | $707.95 | $724.44 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $407.38 Typical High $524.81 | Professional | None | $54.95 | $407.38 | $524.81 |
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 $776.25 Median $891.25 Typical High $1,023.29 | Professional | None | $776.25 | $891.25 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,258.93 | Professional | None | $645.65 | $1,071.52 | $1,258.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $1,548.82 | Professional | None | $478.63 | $870.96 | $1,548.82 |
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 $537.03 Median $616.60 Typical High $1,122.02 | Professional | None | $537.03 | $616.60 | $1,122.02 |
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 $309.03 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $549.54 |
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 5.9 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
$427
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.