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 $616.60 Median $3,388.44 Typical High $6,025.60 | Facility | None | $616.60 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $616.60 | Professional | None | $407.38 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,949.84 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $741.31 | Professional | None | $457.09 | $549.54 | $741.31 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $281.84 Typical High $354.81 | Professional | None | $60.26 | $281.84 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,623.41 Median $7,079.46 Typical High $10,232.93 | Facility | None | $5,623.41 | $7,079.46 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $741.31 | Professional | None | $501.19 | $588.84 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $295.12 Median $602.56 Typical High $741.31 | Professional | None | $295.12 | $602.56 | $741.31 |
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 $371.54 Median $457.09 Typical High $812.83 | Professional | None | $371.54 | $457.09 | $812.83 |
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 $204.17 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $81.28 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $302.00 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $60.26 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $40.74 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $281.84 | $426.58 | $426.58 |
Where Utah sits
The same service costs 6.2 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
$302
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.