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 $2,290.87 Median $3,162.28 Typical High $6,025.60 | Facility | None | $2,290.87 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,698.24 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,630.27 | Facility | None | $2,454.71 | $2,570.40 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,905.46 | $1,949.84 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $1,000.00 Typical High $1,380.38 | Professional | None | $138.04 | $1,000.00 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,471.29 Median $13,182.57 Typical High $19,054.61 | Facility | None | $10,471.29 | $13,182.57 | $19,054.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $4,786.30 | Professional | None | $2,630.27 | $3,090.30 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Select Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $3,890.45 | Professional | None | $1,288.25 | $2,754.23 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,819.70 | $3,388.44 |
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 $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $851.14 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $338.84 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,258.93 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $251.19 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,584.89 | $1,584.89 |
Where Utah sits
The same service costs 6.6 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
$1,122
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.