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 $3,162.28 Median $3,311.31 Typical High $6,025.60 | Facility | None | $3,162.28 | $3,311.31 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,398.83 | $3,311.31 | $3,311.31 |
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 $2,691.53 Median $2,818.38 Typical High $5,011.87 | Professional | None | $2,691.53 | $2,818.38 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $1,412.54 Typical High $1,949.84 | Professional | None | $218.78 | $1,412.54 | $1,949.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,715.35 Median $4,365.16 Typical High $6,918.31 | Professional | None | $3,715.35 | $4,365.16 | $6,918.31 |
Select Health Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,995.26 Median $3,890.45 Typical High $7,585.78 | Professional | None | $1,995.26 | $3,890.45 | $7,585.78 |
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 $2,187.76 Median $2,570.40 Typical High $4,786.30 | Professional | None | $2,187.76 | $2,570.40 | $4,786.30 |
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 $1,202.26 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,202.26 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $478.63 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,819.70 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $363.08 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,290.87 | $2,290.87 |
Where Utah sits
The same service costs 7.6 times more in Alaska 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
$1,549
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.