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 $954.99 Median $4,570.88 Typical High $8,912.51 | Facility | None | $954.99 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | None | $741.31 | $954.99 | $954.99 |
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 $831.76 Median $954.99 Typical High $1,318.26 | Professional | None | $831.76 | $954.99 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $467.74 Typical High $630.96 | Professional | None | $54.95 | $467.74 | $630.96 |
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 $891.25 Median $1,047.13 Typical High $1,174.90 | Professional | None | $891.25 | $1,047.13 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $1,047.13 Typical High $1,318.26 | Professional | None | $478.63 | $1,047.13 | $1,318.26 |
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 $660.69 Median $812.83 Typical High $1,479.11 | Professional | None | $660.69 | $812.83 | $1,479.11 |
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 $371.54 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $371.54 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $676.08 |
Where Utah sits
The same service costs 7.2 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.