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 $223.87 Median $2,951.21 Typical High $4,570.88 | Facility | None | $223.87 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $309.03 | Professional | None | $177.83 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,288.25 | $1,348.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $371.54 | Professional | None | $213.80 | $269.15 | $371.54 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $199.53 | Professional | None | $125.89 | $162.18 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $5,495.41 | Facility | None | $3,019.95 | $3,801.89 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $338.84 | Professional | None | $218.78 | $281.84 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $478.63 | Professional | None | $162.18 | $302.00 | $478.63 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $380.19 | Professional | None | $169.82 | $223.87 | $380.19 |
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 $109.65 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $165.96 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $154.88 | $158.49 | $199.53 |
Where Utah sits
The same service costs 4.6 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
$200
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.