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 $1,380.38 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,380.38 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,380.38 | $1,380.38 |
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 $1,288.25 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,318.26 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $676.08 Typical High $933.25 | Professional | None | $56.23 | $676.08 | $933.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,621.81 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,698.24 | $2,041.74 |
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 $1,000.00 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,148.15 | $2,290.87 |
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 $575.44 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $977.24 |
Where Utah sits
The same service costs 6.6 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
$741
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.