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 $977.24 Median $3,162.28 Typical High $6,025.60 | Facility | None | $977.24 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $977.24 | Professional | None | $707.95 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $3,890.45 | Facility | None | $3,715.35 | $3,801.89 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,659.59 | Professional | None | $891.25 | $977.24 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $478.63 Typical High $660.69 | Professional | None | $83.18 | $478.63 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,302.69 Median $15,135.61 Typical High $21,877.62 | Facility | None | $12,302.69 | $15,135.61 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $2,089.30 | Professional | None | $954.99 | $1,122.02 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,174.90 Typical High $2,344.23 | Professional | None | $562.34 | $1,174.90 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,584.89 | Professional | None | $707.95 | $870.96 | $1,584.89 |
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 $354.81 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $354.81 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $537.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $107.15 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $70.79 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $501.19 | $676.08 | $676.08 |
Where Utah sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 50th of 51
$525
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.