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 $616.60 Median $3,388.44 Typical High $6,025.60 | Facility | None | $616.60 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $616.60 | Professional | None | $389.05 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,148.15 | Facility | None | $1,071.52 | $1,122.02 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $549.54 | Professional | None | $446.68 | $524.81 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $295.12 | Professional | None | $33.11 | $223.87 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,162.28 | $3,981.07 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $630.96 | Professional | None | $537.03 | $562.34 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $645.65 | Professional | None | $363.08 | $549.54 | $645.65 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $794.33 | Professional | None | $316.23 | $512.86 | $794.33 |
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 $309.03 Median $363.08 Typical High $630.96 | Professional | None | $309.03 | $363.08 | $630.96 |
7 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 $194.98 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $194.98 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $77.62 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $295.12 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $58.88 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $38.90 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $426.58 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $6,025.60 Typical High $8,709.64 | Facility | 50 · Both sides | $4,786.30 | $6,025.60 | $8,709.64 |
Where Utah sits
The same service costs 5.8 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
$234
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.