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 $398.11 Median $4,570.88 Typical High $8,912.51 | Facility | None | $398.11 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $562.34 | Professional | None | $316.23 | $398.11 | $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 $380.19 Median $389.05 Typical High $588.84 | Professional | None | $380.19 | $389.05 | $588.84 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $204.17 Typical High $281.84 | Professional | None | $48.98 | $204.17 | $281.84 |
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 $416.87 Median $489.78 Typical High $562.34 | Professional | None | $416.87 | $489.78 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $218.78 Median $489.78 Typical High $602.56 | Professional | None | $218.78 | $489.78 | $602.56 |
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 $302.00 Median $346.74 Typical High $676.08 | Professional | None | $302.00 | $346.74 | $676.08 |
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 $158.49 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $275.42 |
Where Utah sits
The same service costs 11.2 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
$224
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.