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 $1,071.52 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,071.52 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,737.80 | Professional | None | $776.25 | $1,071.52 | $1,737.80 |
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 $933.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $933.25 | $1,071.52 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $501.19 Typical High $691.83 | Professional | None | $83.18 | $501.19 | $691.83 |
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 $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $630.96 Median $1,230.27 Typical High $3,162.28 | Professional | None | $630.96 | $1,230.27 | $3,162.28 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,698.24 | Professional | None | $758.58 | $933.25 | $1,698.24 |
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 $389.05 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $537.03 | $741.31 | $741.31 |
Where Utah sits
The same service costs 11.0 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
$537
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.