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 $489.78 Median $3,162.28 Typical High $6,025.60 | Facility | None | $489.78 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $794.33 | Professional | None | $389.05 | $489.78 | $794.33 |
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 $489.78 Median $524.81 Typical High $794.33 | Professional | None | $489.78 | $524.81 | $794.33 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $239.88 Typical High $354.81 | Professional | None | $54.95 | $239.88 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $724.44 | Professional | None | $537.03 | $630.96 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $776.25 | Professional | None | $416.87 | $630.96 | $776.25 |
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 $398.11 Median $467.74 Typical High $870.96 | Professional | None | $398.11 | $467.74 | $870.96 |
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 $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $275.42 | $338.84 | $338.84 |
Where Utah sits
The same service costs 5.0 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
$269
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.