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 $776.25 Median $3,162.28 Typical High $6,025.60 | Facility | None | $776.25 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $776.25 | Professional | None | $588.84 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $2,754.23 | Facility | None | $2,630.27 | $2,691.53 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,174.90 | Professional | None | $707.95 | $758.58 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $363.08 Typical High $524.81 | Professional | None | $54.95 | $363.08 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,232.93 Typical High $14,791.08 | Facility | None | $7,943.28 | $10,232.93 | $14,791.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,071.52 | Professional | None | $776.25 | $912.01 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Select Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,148.15 | Professional | None | $426.58 | $912.01 | $1,148.15 |
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 $575.44 Median $691.83 Typical High $1,288.25 | Professional | None | $575.44 | $691.83 | $1,288.25 |
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 $295.12 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $549.54 | $549.54 |
Where Utah sits
The same service costs 6.2 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
$407
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.