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 $870.96 Median $3,019.95 Typical High $4,786.30 | Facility | None | $870.96 | $3,019.95 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $3,019.95 | Professional | None | $676.08 | $1,258.93 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,348.96 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,818.38 | Professional | None | $537.03 | $1,479.11 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $954.99 Typical High $1,318.26 | Professional | None | $85.11 | $954.99 | $1,318.26 |
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 $478.63 Median $1,412.54 Typical High $2,238.72 | Professional | None | $478.63 | $1,412.54 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $1,698.24 Typical High $2,691.53 | Professional | None | $478.63 | $1,698.24 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,258.93 Typical High $2,951.21 | Professional | None | $380.19 | $1,258.93 | $2,951.21 |
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 $338.84 Median $436.52 Typical High $1,513.56 | Professional | 52 · Reduced service | $338.84 | $436.52 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $177.83 Typical High $602.56 | Professional | 53 · Discontinued | $134.90 | $177.83 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $660.69 Typical High $2,290.87 | Professional | 54 · Surgery only | $501.19 | $660.69 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $131.83 Typical High $457.09 | Professional | 55 · Aftercare only | $100.00 | $131.83 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $302.00 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $616.60 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $467.74 | $616.60 | $2,137.96 |
Where Utah sits
The same service costs 4.9 times more in Alaska than in Texas. 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· 49th of 51
$1,000
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.