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 $173.78 Median $2,951.21 Typical High $4,570.88 | Facility | None | $173.78 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | None | $162.18 | $181.97 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $794.33 | Facility | None | $758.58 | $776.25 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $295.12 | Professional | None | $173.78 | $190.55 | $295.12 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $194.98 | Professional | None | $107.15 | $141.25 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $275.42 | Professional | None | $199.53 | $239.88 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $346.74 | Professional | None | $123.03 | $245.47 | $346.74 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $316.23 | Professional | None | $147.91 | $173.78 | $316.23 |
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 $81.28 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $32.36 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $123.03 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $26.30 Typical High $28.84 | Professional | 55 · Aftercare only | $24.55 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $123.03 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $114.82 | $123.03 | $134.90 |
Where Utah sits
The same service costs 4.6 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
$166
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.