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 $3,162.28 Typical High $4,570.88 | Facility | None | $660.69 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
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 $575.44 Median $660.69 Typical High $933.25 | Professional | None | $575.44 | $660.69 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $331.13 Typical High $426.58 | Professional | None | $33.88 | $331.13 | $426.58 |
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 $630.96 Median $741.31 Typical High $812.83 | Professional | None | $630.96 | $741.31 | $812.83 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $346.74 Median $741.31 Typical High $1,737.80 | Professional | None | $346.74 | $741.31 | $1,737.80 |
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 $467.74 Median $575.44 Typical High $1,047.13 | Professional | None | $467.74 | $575.44 | $1,047.13 |
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 $263.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $467.74 | $467.74 |
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 5.5 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
$372
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.