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 $302.00 Median $2,884.03 Typical High $4,786.30 | Facility | None | $302.00 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $776.25 | Professional | None | $251.19 | $416.87 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,202.26 | Facility | None | $1,148.15 | $1,174.90 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $562.34 | Professional | None | $288.40 | $389.05 | $562.34 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $239.88 Typical High $323.59 | Professional | None | $26.92 | $239.88 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $6,165.95 | Facility | None | $3,235.94 | $4,265.80 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $524.81 | Professional | None | $288.40 | $416.87 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $173.78 Median $436.52 Typical High $676.08 | Professional | None | $173.78 | $436.52 | $676.08 |
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 $229.09 Median $363.08 Typical High $645.65 | Professional | None | $229.09 | $363.08 | $645.65 |
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 $151.36 Median $162.18 Typical High $275.42 | Professional | 52 · Reduced service | $151.36 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $109.65 | Professional | 53 · Discontinued | $60.26 | $66.07 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $407.38 | Professional | 54 · Surgery only | $229.09 | $245.47 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $81.28 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $54.95 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $380.19 |
Where Utah sits
The same service costs 4.6 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
$275
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.