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 $1,698.24 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,698.24 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
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 $1,513.56 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,659.59 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $741.31 Typical High $1,047.13 | Professional | None | $114.82 | $741.31 | $1,047.13 |
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 $1,621.81 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,949.84 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,995.26 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,479.11 | $2,754.23 |
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 $616.60 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $616.60 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $933.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $186.21 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,202.26 | $1,202.26 |
Where Utah sits
The same service costs 6.9 times more in Alaska 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
$832
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.