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 $151.36 Median $2,884.03 Typical High $4,786.30 | Facility | None | $151.36 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $190.55 | Professional | None | $114.82 | $151.36 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $109.65 Typical High $112.20 | Facility | None | $104.71 | $109.65 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $263.03 | Professional | None | $144.54 | $162.18 | $263.03 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Professional | None | $79.43 | $117.49 | $162.18 |
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 $141.25 Median $208.93 Typical High $245.47 | Professional | None | $141.25 | $208.93 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $91.20 Median $213.80 Typical High $316.23 | Professional | None | $91.20 | $213.80 | $316.23 |
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 $114.82 Median $151.36 Typical High $269.15 | Professional | None | $114.82 | $151.36 | $269.15 |
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 $66.07 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $30.20 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $125.89 | Professional | 54 · Surgery only | $100.00 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.14 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $104.71 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $93.33 | $104.71 | $117.49 |
Where Utah sits
The same service costs 3.6 times more in Wisconsin 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
$138
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.