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 $602.56 Median $2,951.21 Typical High $4,570.88 | Facility | None | $602.56 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $707.95 | Professional | None | $602.56 | $676.08 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $645.65 | Facility | None | $616.60 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $977.24 | Professional | None | $537.03 | $691.83 | $977.24 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $380.19 Typical High $602.56 | Professional | None | $56.23 | $380.19 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,548.82 | $1,995.26 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,000.00 | Professional | None | $741.31 | $891.25 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $1,230.27 | Professional | None | $478.63 | $851.14 | $1,230.27 |
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 $512.86 Median $630.96 Typical High $1,000.00 | Professional | None | $512.86 | $630.96 | $1,000.00 |
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 $302.00 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $478.63 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,019.95 Typical High $4,365.16 | Facility | 50 · Both sides | $2,344.23 | $3,019.95 | $4,365.16 |
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
$437
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.