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 $1,621.81 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,621.81 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,621.81 | $1,621.81 |
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 $1,318.26 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,548.82 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $776.25 Typical High $1,047.13 | Professional | None | $83.18 | $776.25 | $1,047.13 |
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 $1,445.44 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,698.24 | $2,187.76 |
Select Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,737.80 Typical High $3,467.37 | Professional | None | $794.33 | $1,737.80 | $3,467.37 |
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 $1,071.52 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,348.96 | $2,398.83 |
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 $588.84 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $870.96 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $177.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $117.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $812.83 | $1,148.15 | $1,148.15 |
Where Utah sits
The same service costs 5.8 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
$813
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.