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 $2,137.96 Median $4,570.88 Typical High $8,912.51 | Facility | None | $2,137.96 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,479.11 | $2,137.96 | $2,137.96 |
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 $1,621.81 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,905.46 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $912.01 Typical High $1,202.26 | Professional | None | $112.20 | $912.01 | $1,202.26 |
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 $1,778.28 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,041.74 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $977.24 Median $2,089.30 Typical High $5,248.07 | Professional | None | $977.24 | $2,089.30 | $5,248.07 |
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 $1,288.25 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,659.59 | $2,951.21 |
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 $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $741.31 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $295.12 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,096.48 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $218.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $147.91 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,479.11 | $1,479.11 |
Where Utah sits
The same service costs 5.8 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
$977
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.