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 $831.76 Median $4,570.88 Typical High $9,772.37 | Facility | None | $831.76 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $831.76 | Professional | None | $588.84 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $2,754.23 | Facility | None | $2,630.27 | $2,691.53 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,096.48 | Professional | None | $676.08 | $776.25 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $524.81 | Professional | None | $302.00 | $398.11 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,232.93 Typical High $14,791.08 | Facility | None | $7,943.28 | $10,232.93 | $14,791.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,096.48 | Professional | None | $741.31 | $870.96 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $891.25 Typical High $3,548.13 | Professional | None | $407.38 | $891.25 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,202.26 | Professional | None | $537.03 | $676.08 | $1,202.26 |
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 $295.12 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $120.23 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $446.68 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $89.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $588.84 |
Where Utah sits
The same service costs 9.8 times more in Oklahoma 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
$447
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.