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 $562.34 Median $4,570.88 Typical High $12,302.69 | Facility | None | $562.34 | $4,570.88 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $812.83 | Professional | None | $446.68 | $562.34 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $812.83 | Professional | None | $512.86 | $562.34 | $812.83 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $389.05 | Professional | None | $229.09 | $309.03 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $12,022.64 Typical High $17,378.01 | Facility | None | $9,120.11 | $12,022.64 | $17,378.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | None | $537.03 | $630.96 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $295.12 Median $630.96 Typical High $1,071.52 | Professional | None | $295.12 | $630.96 | $1,071.52 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $891.25 | Professional | None | $398.11 | $489.78 | $891.25 |
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 $223.87 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $223.87 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $89.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $44.67 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $398.11 | $398.11 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,197.01 Typical High $26,302.68 | Facility | 50 · Both sides | $13,803.84 | $18,197.01 | $26,302.68 |
Where Utah sits
The same service costs 9.5 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.