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 $467.74 Median $3,388.44 Typical High $6,025.60 | Facility | None | $467.74 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $467.74 | Professional | None | $354.81 | $467.74 | $467.74 |
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 $426.58 Median $457.09 Typical High $691.83 | Professional | None | $426.58 | $457.09 | $691.83 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $245.47 Typical High $323.59 | Professional | None | $60.26 | $245.47 | $323.59 |
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 $467.74 Median $549.54 Typical High $645.65 | Professional | None | $467.74 | $549.54 | $645.65 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $263.03 Median $549.54 Typical High $691.83 | Professional | None | $263.03 | $549.54 | $691.83 |
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 $346.74 Median $407.38 Typical High $776.25 | Professional | None | $346.74 | $407.38 | $776.25 |
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 $177.83 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $177.83 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $263.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $245.47 | $331.13 | $331.13 |
Where Utah sits
The same service costs 7.1 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
$275
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.