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 $1,318.26 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,318.26 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,318.26 | $1,318.26 |
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 $1,122.02 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,318.26 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $630.96 Typical High $851.14 | Professional | None | $83.18 | $630.96 | $851.14 |
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 $1,202.26 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,412.54 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $676.08 Median $1,412.54 Typical High $3,548.13 | Professional | None | $676.08 | $1,412.54 | $3,548.13 |
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 $891.25 Median $1,122.02 Typical High $1,995.26 | Professional | None | $891.25 | $1,122.02 | $1,995.26 |
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 $501.19 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $912.01 | $912.01 |
Where Utah sits
The same service costs 5.9 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
$692
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.