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 $562.34 Median $4,570.88 Typical High $8,912.51 | Facility | None | $562.34 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $562.34 | Professional | None | $416.87 | $562.34 | $562.34 |
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 $501.19 Median $537.03 Typical High $812.83 | Professional | None | $501.19 | $537.03 | $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 $549.54 Median $645.65 Typical High $741.31 | Professional | None | $549.54 | $645.65 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
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 $302.00 Median $645.65 Typical High $1,659.59 | Professional | None | $302.00 | $645.65 | $1,659.59 |
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 $407.38 Median $467.74 Typical High $891.25 | Professional | None | $407.38 | $467.74 | $891.25 |
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 $208.93 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $208.93 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $83.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $41.69 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $398.11 |
Where Utah sits
The same service costs 7.1 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
$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.