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 $660.69 Median $4,570.88 Typical High $9,120.11 | Facility | None | $660.69 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $676.08 | Professional | None | $512.86 | $660.69 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $912.01 | Professional | None | $575.44 | $645.65 | $912.01 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $426.58 | Professional | None | $257.04 | $338.84 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $10,471.29 | Facility | None | $5,754.40 | $7,244.36 | $10,471.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $794.33 | Professional | None | $616.60 | $724.44 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Select Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $338.84 Median $724.44 Typical High $1,047.13 | Professional | None | $338.84 | $724.44 | $1,047.13 |
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 $457.09 Median $562.34 Typical High $1,023.29 | Professional | None | $457.09 | $562.34 | $1,023.29 |
7 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 $257.04 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $380.19 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $354.81 | $457.09 | $457.09 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $10,964.78 Typical High $15,848.93 | Facility | 50 · Both sides | $8,709.64 | $10,964.78 | $15,848.93 |
Where Utah sits
The same service costs 10.0 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
$363
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.