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 $1,230.27 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,230.27 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | None | $891.25 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,235.94 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,174.90 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $575.44 Typical High $758.58 | Professional | None | $54.95 | $575.44 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,471.29 Typical High $15,135.61 | Facility | None | $7,943.28 | $10,471.29 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,288.25 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Professional | None | $602.56 | $1,318.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,819.70 | Professional | None | $812.83 | $1,023.29 | $1,819.70 |
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 $446.68 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $660.69 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $616.60 | $870.96 | $870.96 |
Where Utah sits
The same service costs 5.6 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
$631
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.