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 $1,479.11 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,479.11 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,479.11 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $6,165.95 | Facility | None | $5,888.44 | $6,025.60 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,445.44 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $630.96 Typical High $891.25 | Professional | None | $85.11 | $630.96 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,218.10 Median $21,379.62 Typical High $30,902.95 | Facility | None | $16,218.10 | $21,379.62 | $30,902.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,659.59 | $1,905.46 |
Select Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $812.83 Median $1,621.81 Typical High $2,089.30 | Professional | None | $812.83 | $1,621.81 | $2,089.30 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,918.31 Typical High $15,848.93 | Facility | None | $2,398.83 | $6,918.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,258.93 | $2,344.23 |
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 $537.03 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $537.03 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $213.80 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $794.33 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $107.15 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $741.31 | $1,023.29 | $1,023.29 |
Where Utah sits
The same service costs 8.7 times more in Oklahoma 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
$724
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.