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 $537.03 Median $4,570.88 Typical High $8,912.51 | Facility | None | $537.03 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $758.58 | Professional | None | $426.58 | $537.03 | $758.58 |
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 $478.63 Median $537.03 Typical High $758.58 | Professional | None | $478.63 | $537.03 | $758.58 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $275.42 Typical High $363.08 | Professional | None | $33.88 | $275.42 | $363.08 |
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 $512.86 Median $602.56 Typical High $676.08 | Professional | None | $512.86 | $602.56 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $977.24 | Professional | None | $281.84 | $602.56 | $977.24 |
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 $380.19 Median $478.63 Typical High $851.14 | Professional | None | $380.19 | $478.63 | $851.14 |
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 $213.80 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $213.80 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $64.57 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $42.66 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $380.19 | $380.19 |
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 6.0 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
$309
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.