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 $1,288.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,288.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | None | $977.24 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,888.44 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,288.25 | $1,778.28 |
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 $14,125.38 Median $19,054.61 Typical High $27,542.29 | Facility | None | $14,125.38 | $19,054.61 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,380.38 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $660.69 Median $1,380.38 Typical High $3,311.31 | Professional | None | $660.69 | $1,380.38 | $3,311.31 |
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 $870.96 Median $1,122.02 Typical High $1,949.84 | Professional | None | $870.96 | $1,122.02 | $1,949.84 |
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 $489.78 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $489.78 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $912.01 | $912.01 |
Where Utah sits
The same service costs 6.3 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
$661
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.