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 $269.15 Median $2,884.03 Typical High $4,786.30 | Facility | None | $269.15 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $316.23 | Professional | None | $263.03 | $269.15 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $575.44 Typical High $588.84 | Facility | None | $549.54 | $575.44 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $302.00 | Professional | None | $234.42 | $275.42 | $302.00 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $288.40 | Professional | None | $162.18 | $204.17 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,691.53 | Facility | None | $1,479.11 | $1,819.70 | $2,691.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $478.63 | Professional | None | $309.03 | $407.38 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $309.03 | Professional | None | $204.17 | $263.03 | $309.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $537.03 | Professional | None | $213.80 | $371.54 | $537.03 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $354.81 | Professional | None | $173.78 | $223.87 | $354.81 |
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 $131.83 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $223.87 |
Where Utah sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 43rd of 51
$224
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.