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 $524.81 Median $4,570.88 Typical High $8,912.51 | Facility | None | $524.81 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | None | $407.38 | $524.81 | $524.81 |
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 $489.78 Median $512.86 Typical High $812.83 | Professional | None | $489.78 | $512.86 | $812.83 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $245.47 Typical High $354.81 | Professional | None | $47.86 | $245.47 | $354.81 |
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 $537.03 Median $630.96 Typical High $724.44 | Professional | None | $537.03 | $630.96 | $724.44 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $1,905.46 | Professional | None | $288.40 | $630.96 | $1,905.46 |
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 $389.05 Median $457.09 Typical High $870.96 | Professional | None | $389.05 | $457.09 | $870.96 |
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 $204.17 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $302.00 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $363.08 |
Where Utah sits
The same service costs 10.2 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
$288
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.