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 $112.20 Median $144.54 Typical High $4,570.88 | Facility | None | $112.20 | $144.54 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $158.49 | Professional | None | $93.33 | $120.23 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $97.72 Typical High $100.00 | Facility | None | $91.20 | $97.72 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $190.55 | Professional | None | $107.15 | $141.25 | $190.55 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $724.44 | Facility | None | $398.11 | $501.19 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $173.78 | Professional | None | $112.20 | $147.91 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $64.57 Median $154.88 Typical High $234.42 | Professional | None | $64.57 | $154.88 | $234.42 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $194.98 | Professional | None | $85.11 | $114.82 | $194.98 |
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 $54.95 Median $57.54 Typical High $72.44 | Professional | 52 · Reduced service | $54.95 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.91 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $83.18 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $81.28 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $77.62 | $81.28 | $100.00 |
Where Utah sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 47th of 51
$112
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.