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 $416.87 Median $3,162.28 Typical High $9,332.54 | Facility | None | $416.87 | $3,162.28 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $660.69 | Professional | None | $371.54 | $446.68 | $660.69 |
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 $446.68 Median $467.74 Typical High $691.83 | Professional | None | $446.68 | $467.74 | $691.83 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $257.04 Typical High $398.11 | Professional | None | $54.95 | $257.04 | $398.11 |
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 $478.63 Median $562.34 Typical High $691.83 | Professional | None | $478.63 | $562.34 | $691.83 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $831.76 | Professional | None | $288.40 | $602.56 | $831.76 |
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 $354.81 Median $426.58 Typical High $741.31 | Professional | None | $354.81 | $426.58 | $741.31 |
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 $194.98 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $288.40 | $309.03 |
Where Utah sits
The same service costs 4.3 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
$324
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.