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 $234.42 Median $2,951.21 Typical High $4,570.88 | Facility | None | $234.42 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $257.04 | Professional | None | $194.98 | $234.42 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $109.65 | Facility | None | $102.33 | $107.15 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $354.81 | Professional | None | $208.93 | $234.42 | $354.81 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | None | $100.00 | $144.54 | $199.53 |
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 $208.93 Median $245.47 Typical High $338.84 | Professional | None | $208.93 | $245.47 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $416.87 | Professional | None | $141.25 | $275.42 | $416.87 |
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 $158.49 Median $194.98 Typical High $338.84 | Professional | None | $158.49 | $194.98 | $338.84 |
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 $97.72 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $97.72 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $38.90 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.50 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $162.18 | $181.97 |
Where Utah sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 48th of 51
$195
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.