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 $363.08 Median $3,162.28 Typical High $4,570.88 | Facility | None | $363.08 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $363.08 | Professional | None | $275.42 | $363.08 | $363.08 |
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 $331.13 Median $354.81 Typical High $537.03 | Professional | None | $331.13 | $354.81 | $537.03 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $263.03 | Professional | None | $173.78 | $218.78 | $263.03 |
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 $363.08 Median $426.58 Typical High $501.19 | Professional | None | $363.08 | $426.58 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $199.53 Median $426.58 Typical High $524.81 | Professional | None | $199.53 | $426.58 | $524.81 |
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 $263.03 Median $316.23 Typical High $588.84 | Professional | None | $263.03 | $316.23 | $588.84 |
7 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 $138.04 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $204.17 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $190.55 | $257.04 | $257.04 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,244.36 Median $9,772.37 Typical High $14,125.38 | Facility | 50 · Both sides | $7,244.36 | $9,772.37 | $14,125.38 |
Where Utah sits
The same service costs 6.0 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
$245
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.