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 $645.65 Median $3,388.44 Typical High $6,025.60 | Facility | None | $645.65 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | None | $537.03 | $645.65 | $645.65 |
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 $549.54 Median $549.54 Typical High $660.69 | Professional | None | $549.54 | $549.54 | $660.69 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $309.03 Typical High $416.87 | Professional | None | $53.70 | $309.03 | $416.87 |
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 $724.44 Median $776.25 Typical High $851.14 | Professional | None | $724.44 | $776.25 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $912.01 | Professional | None | $489.78 | $776.25 | $912.01 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $407.38 Median $707.95 Typical High $1,047.13 | Professional | None | $407.38 | $707.95 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $812.83 | Professional | None | $389.05 | $467.74 | $812.83 |
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 $269.15 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $457.09 |
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
$324
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.