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 $1,445.44 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,445.44 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,202.26 | Facility | None | $1,148.15 | $1,174.90 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,348.96 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $630.96 Typical High $870.96 | Professional | None | $56.23 | $630.96 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,235.94 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,479.11 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $741.31 Median $1,548.82 Typical High $2,041.74 | Professional | None | $741.31 | $1,548.82 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,089.30 | Professional | None | $933.25 | $1,148.15 | $2,089.30 |
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 $512.86 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $104.71 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $724.44 | $1,023.29 | $1,023.29 |
Where Utah sits
The same service costs 5.9 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
$692
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.