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 $512.86 Median $3,388.44 Typical High $6,025.60 | Facility | None | $512.86 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $524.81 | Professional | None | $426.58 | $512.86 | $524.81 |
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 $537.03 Median $549.54 Typical High $851.14 | Professional | None | $537.03 | $549.54 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $239.88 Typical High $371.54 | Professional | None | $54.95 | $239.88 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $794.33 | Professional | None | $588.84 | $691.83 | $794.33 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $831.76 | Professional | None | $446.68 | $691.83 | $831.76 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $954.99 | Professional | None | $426.58 | $501.19 | $954.99 |
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 $213.80 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $354.81 |
Where Utah sits
The same service costs 7.2 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
$282
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.