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 $1,000.00 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,000.00 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
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 $831.76 Median $954.99 Typical High $1,318.26 | Professional | None | $831.76 | $954.99 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $645.65 | Professional | None | $380.19 | $489.78 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $891.25 | $1,047.13 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $2,137.96 | Professional | None | $562.34 | $1,096.48 | $2,137.96 |
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 $660.69 Median $812.83 Typical High $1,479.11 | Professional | None | $660.69 | $812.83 | $1,479.11 |
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 $363.08 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $363.08 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $144.54 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $549.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $109.65 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $72.44 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $512.86 | $707.95 | $707.95 |
Where Utah sits
The same service costs 5.4 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
$537
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.