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 $1,000.00 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,000.00 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,445.44 | Professional | None | $776.25 | $1,000.00 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,949.84 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,380.38 | Professional | None | $870.96 | $1,000.00 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $501.19 Typical High $676.08 | Professional | None | $54.95 | $501.19 | $676.08 |
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 $933.25 Median $1,096.48 Typical High $1,230.27 | Professional | None | $933.25 | $1,096.48 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $512.86 Median $1,096.48 Typical High $2,511.89 | Professional | None | $512.86 | $1,096.48 | $2,511.89 |
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 $691.83 Median $870.96 Typical High $1,548.82 | Professional | None | $691.83 | $870.96 | $1,548.82 |
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 $389.05 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $549.54 | $707.95 | $707.95 |
Where Utah sits
The same service costs 7.9 times more in Oklahoma 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
$525
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.