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 $295.12 Median $457.09 Typical High $4,570.88 | Facility | None | $295.12 | $457.09 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $457.09 | Professional | None | $295.12 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,288.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $501.19 | Professional | None | $338.84 | $426.58 | $501.19 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $251.19 Typical High $380.19 | Professional | None | $27.54 | $251.19 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $6,918.31 | Facility | None | $3,630.78 | $4,786.30 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $660.69 | Professional | None | $363.08 | $562.34 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $239.88 Median $645.65 Typical High $1,288.25 | Professional | None | $239.88 | $645.65 | $1,288.25 |
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 $263.03 Median $407.38 Typical High $645.65 | Professional | None | $263.03 | $407.38 | $645.65 |
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 $147.91 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $147.91 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $58.88 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $44.67 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $29.51 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $208.93 | $316.23 | $316.23 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $5,495.41 Median $7,244.36 Typical High $10,471.29 | Facility | 50 · Both sides | $5,495.41 | $7,244.36 | $10,471.29 |
Where Utah sits
The same service costs 5.5 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
$288
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.