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 $9,120.11 | Facility | None | $933.25 | $4,570.88 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,122.02 | Professional | None | $758.58 | $933.25 | $1,122.02 |
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 $954.99 Median $1,000.00 Typical High $1,548.82 | Professional | None | $954.99 | $1,000.00 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $338.84 Typical High $630.96 | Professional | None | $109.65 | $338.84 | $630.96 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,513.56 | Professional | None | $794.33 | $1,202.26 | $1,513.56 |
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 $758.58 Median $912.01 Typical High $1,698.24 | Professional | None | $758.58 | $912.01 | $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 $380.19 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $660.69 | $660.69 |
Where Utah sits
The same service costs 8.5 times more in Oklahoma 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
$417
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.