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 $602.56 Median $4,570.88 Typical High $9,120.11 | Facility | None | $602.56 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $630.96 | Professional | None | $457.09 | $602.56 | $630.96 |
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 $524.81 Median $602.56 Typical High $851.14 | Professional | None | $524.81 | $602.56 | $851.14 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $302.00 Typical High $398.11 | Professional | None | $33.88 | $302.00 | $398.11 |
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 $575.44 Median $676.08 Typical High $758.58 | Professional | None | $575.44 | $676.08 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $1,230.27 | Professional | None | $316.23 | $676.08 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $933.25 | Professional | None | $416.87 | $524.81 | $933.25 |
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 $234.42 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $46.77 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $426.58 | $426.58 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,317.64 Median $10,715.19 Typical High $15,488.17 | Facility | 50 · Both sides | $8,317.64 | $10,715.19 | $15,488.17 |
Where Utah sits
The same service costs 8.7 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
$339
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.