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 $562.34 Median $3,388.44 Typical High $6,025.60 | Facility | None | $562.34 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | None | $457.09 | $562.34 | $562.34 |
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 $562.34 Median $562.34 Typical High $831.76 | Professional | None | $562.34 | $562.34 | $831.76 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $263.03 Typical High $407.38 | Professional | None | $54.95 | $263.03 | $407.38 |
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 $630.96 Median $707.95 Typical High $794.33 | Professional | None | $630.96 | $707.95 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $302.00 Median $707.95 Typical High $891.25 | Professional | None | $302.00 | $707.95 | $891.25 |
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 $436.52 Median $537.03 Typical High $1,071.52 | Professional | None | $436.52 | $537.03 | $1,071.52 |
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 $229.09 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $398.11 | $398.11 |
Where Utah sits
The same service costs 6.5 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
$316
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.