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 $1,584.89 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,584.89 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,584.89 | $1,584.89 |
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 $1,412.54 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,548.82 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $660.69 Typical High $933.25 | Professional | None | $114.82 | $660.69 | $933.25 |
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 $1,513.56 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,778.28 | $2,089.30 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,778.28 Typical High $3,162.28 | Professional | None | $870.96 | $1,778.28 | $3,162.28 |
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 $1,122.02 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,348.96 | $2,570.40 |
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 $575.44 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $575.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $229.09 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $114.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $1,122.02 | $1,122.02 |
Where Utah sits
The same service costs 7.2 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
$759
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.