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 $1,174.90 Median $3,162.28 Typical High $4,570.88 | Facility | None | $1,174.90 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $891.25 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,235.94 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,174.90 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $562.34 Typical High $741.31 | Professional | None | $83.18 | $562.34 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,471.29 Typical High $15,135.61 | Facility | None | $7,943.28 | $10,471.29 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,288.25 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $602.56 Median $1,288.25 Typical High $1,621.81 | Professional | None | $602.56 | $1,288.25 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $8,912.51 | Facility | None | $1,000.00 | $3,311.31 | $8,912.51 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,819.70 | Professional | None | $812.83 | $1,023.29 | $1,819.70 |
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 $457.09 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $457.09 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $676.08 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $812.83 | $812.83 |
Where Utah sits
The same service costs 5.8 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
$617
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.