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 $218.78 Median $2,951.21 Typical High $4,570.88 | Facility | None | $218.78 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $269.15 | Professional | None | $194.98 | $223.87 | $269.15 |
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 $213.80 Median $239.88 Typical High $398.11 | Professional | None | $213.80 | $239.88 | $398.11 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $229.09 | Professional | None | $134.90 | $169.82 | $229.09 |
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 $234.42 Median $309.03 Typical High $371.54 | Professional | None | $234.42 | $309.03 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $134.90 Median $323.59 Typical High $467.74 | Professional | None | $134.90 | $323.59 | $467.74 |
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 $173.78 Median $223.87 Typical High $398.11 | Professional | None | $173.78 | $223.87 | $398.11 |
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 $102.33 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $186.21 | Professional | 54 · Surgery only | $154.88 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $154.88 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $144.54 | $154.88 | $173.78 |
Where Utah sits
The same service costs 4.4 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
$200
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.