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 $1,949.84 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,949.84 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $5,011.87 | Facility | None | $4,786.30 | $4,897.79 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,698.24 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $794.33 Typical High $1,096.48 | Professional | None | $85.11 | $794.33 | $1,096.48 |
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 $2,187.76 Median $2,290.87 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,290.87 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $2,570.40 | Professional | None | $1,445.44 | $2,238.72 | $2,570.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,202.26 | $2,137.96 | $3,388.44 |
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 $1,174.90 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,380.38 | $2,398.83 |
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 $794.33 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,380.38 | $1,380.38 |
Where Utah sits
The same service costs 7.2 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
$832
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.