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 $346.74 Median $2,951.21 Typical High $4,570.88 | Facility | None | $346.74 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $446.68 | Professional | None | $346.74 | $389.05 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $363.08 | Facility | None | $338.84 | $354.81 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $549.54 | Professional | None | $309.03 | $407.38 | $549.54 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $239.88 Typical High $371.54 | Professional | None | $27.54 | $239.88 | $371.54 |
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 $426.58 Median $537.03 Typical High $630.96 | Professional | None | $426.58 | $537.03 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $234.42 Median $489.78 Typical High $758.58 | Professional | None | $234.42 | $489.78 | $758.58 |
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 $295.12 Median $371.54 Typical High $602.56 | Professional | None | $295.12 | $371.54 | $602.56 |
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 $173.78 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $275.42 |
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 5.0 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
$275
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.