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 $4,168.69 Median $6,606.93 Typical High $9,120.11 | Facility | None | $4,168.69 | $6,606.93 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $6,606.93 | Professional | None | $5,011.87 | $6,606.93 | $6,606.93 |
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 $5,623.41 Median $6,165.95 Typical High $8,128.31 | Professional | None | $5,623.41 | $6,165.95 | $8,128.31 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $2,951.21 Typical High $3,981.07 | Professional | None | $323.59 | $2,951.21 | $3,981.07 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,165.95 Median $6,918.31 Typical High $8,128.31 | Professional | None | $6,165.95 | $6,918.31 | $8,128.31 |
Select Health Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Facility | None | $8,912.51 | $8,912.51 | $8,912.51 |
Select Health Setting Professional Modifier None Typical Low $5,248.07 Median $7,943.28 Typical High $9,332.54 | Professional | None | $5,248.07 | $7,943.28 | $9,332.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $4,073.80 Median $6,918.31 Typical High $16,218.10 | Professional | None | $4,073.80 | $6,918.31 | $16,218.10 |
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 $4,365.16 Median $5,011.87 Typical High $9,120.11 | Professional | None | $4,365.16 | $5,011.87 | $9,120.11 |
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 $2,570.40 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $2,570.40 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $1,023.29 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $3,801.89 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $758.58 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $512.86 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $3,548.13 | $4,570.88 | $4,570.88 |
Where Utah sits
The same service costs 20.0 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
$3,020
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.