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 $181.97 Median $2,951.21 Typical High $4,570.88 | Facility | None | $181.97 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $208.93 | Professional | None | $123.03 | $181.97 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $91.20 Typical High $93.33 | Facility | None | $87.10 | $91.20 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $204.17 | Professional | None | $173.78 | $186.21 | $204.17 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $162.18 | Professional | None | $75.86 | $114.82 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $891.25 | Facility | None | $478.63 | $602.56 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $281.84 | Professional | None | $194.98 | $239.88 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $181.97 | Professional | None | $131.83 | $154.88 | $181.97 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $380.19 | Professional | None | $123.03 | $223.87 | $380.19 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $223.87 | Professional | None | $114.82 | $138.04 | $223.87 |
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 $79.43 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $151.36 | Professional | 54 · Surgery only | $117.49 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $30.20 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $141.25 |
Where Utah sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 46th of 51
$138
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.