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 $1,513.56 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,513.56 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,235.94 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,348.96 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $660.69 Typical High $870.96 | Professional | None | $83.18 | $660.69 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,471.29 Typical High $15,135.61 | Facility | None | $7,943.28 | $10,471.29 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,479.11 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $691.83 Median $1,479.11 Typical High $4,677.35 | Professional | None | $691.83 | $1,479.11 | $4,677.35 |
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 $933.25 Median $1,174.90 Typical High $2,089.30 | Professional | None | $933.25 | $1,174.90 | $2,089.30 |
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 $524.81 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $524.81 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $208.93 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $794.33 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $741.31 | $1,047.13 | $1,047.13 |
Where Utah sits
The same service costs 5.6 times more in Alaska 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
$724
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.