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 $933.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $933.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $933.25 | Professional | None | $676.08 | $933.25 | $933.25 |
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 $831.76 Median $912.01 Typical High $1,348.96 | Professional | None | $831.76 | $912.01 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $398.11 Typical High $575.44 | Professional | None | $56.23 | $398.11 | $575.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,230.27 | Professional | None | $891.25 | $1,047.13 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $1,905.46 | Professional | None | $549.54 | $1,047.13 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,479.11 | Professional | None | $660.69 | $794.33 | $1,479.11 |
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 $338.84 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $512.86 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $660.69 | $660.69 |
Where Utah sits
The same service costs 6.9 times more in Alaska 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
$457
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.