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 $426.58 Median $3,388.44 Typical High $6,025.60 | Facility | None | $426.58 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $691.83 | Professional | None | $323.59 | $426.58 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $630.96 | Professional | None | $389.05 | $416.87 | $630.96 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $295.12 | Professional | None | $158.49 | $223.87 | $295.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $588.84 | Professional | None | $426.58 | $501.19 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $616.60 | Professional | None | $331.13 | $501.19 | $616.60 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $691.83 | Professional | None | $316.23 | $371.54 | $691.83 |
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 $162.18 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $64.57 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $239.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $47.86 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $223.87 | $302.00 | $302.00 |
Where Utah sits
The same service costs 5.8 times more in Alaska 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
$240
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.