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 $3,388.44 Typical High $6,025.60 | Facility | None | $562.34 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | None | $436.52 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $851.14 | Professional | None | $524.81 | $537.03 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $288.40 Typical High $389.05 | Professional | None | $54.95 | $288.40 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $9,549.93 | Facility | None | $4,786.30 | $6,606.93 | $9,549.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $776.25 | Professional | None | $575.44 | $676.08 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $309.03 Median $676.08 Typical High $831.76 | Professional | None | $309.03 | $676.08 | $831.76 |
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 $416.87 Median $489.78 Typical High $933.25 | Professional | None | $416.87 | $489.78 | $933.25 |
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 $218.78 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $302.00 | $389.05 | $389.05 |
Where Utah sits
The same service costs 8.9 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
$309
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.