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 $1,122.02 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,122.02 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
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 $954.99 Median $1,096.48 Typical High $1,513.56 | Professional | None | $954.99 | $1,096.48 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $537.03 Typical High $724.44 | Professional | None | $54.95 | $537.03 | $724.44 |
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 $1,023.29 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,202.26 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,202.26 Typical High $3,715.35 | Professional | None | $562.34 | $1,202.26 | $3,715.35 |
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 $758.58 Median $1,000.00 Typical High $1,698.24 | Professional | None | $758.58 | $1,000.00 | $1,698.24 |
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 $426.58 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $776.25 | $776.25 |
Where Utah sits
The same service costs 6.6 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
$575
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.