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 $147.91 Median $2,951.21 Typical High $4,570.88 | Facility | None | $147.91 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $239.88 | Professional | None | $120.23 | $165.96 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $154.88 | Facility | None | $144.54 | $151.36 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $288.40 | Professional | None | $141.25 | $158.49 | $288.40 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $199.53 | Professional | None | $100.00 | $141.25 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $5,495.41 | Facility | None | $3,019.95 | $3,801.89 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $281.84 | Professional | None | $169.82 | $229.09 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $91.20 Median $245.47 Typical High $363.08 | Professional | None | $91.20 | $245.47 | $363.08 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $295.12 | Professional | None | $117.49 | $165.96 | $295.12 |
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 $74.13 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $29.51 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $117.49 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $109.65 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $102.33 | $109.65 | $128.82 |
Where Utah sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 48th of 51
$166
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.