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 $416.87 Median $3,162.28 Typical High $8,709.64 | Facility | None | $416.87 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $2,137.96 Typical High $2,137.96 | Professional | None | $416.87 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $4,168.69 Typical High $4,265.80 | Facility | None | $3,981.07 | $4,168.69 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,584.89 Typical High $2,630.27 | Professional | None | $512.86 | $1,584.89 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $1,174.90 Typical High $1,778.28 | Professional | None | $194.98 | $1,174.90 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,606.93 Median $8,317.64 Typical High $12,022.64 | Facility | None | $6,606.93 | $8,317.64 | $12,022.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $2,951.21 | Professional | None | $549.54 | $870.96 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,677.35 | Professional | None | $602.56 | $2,884.03 | $4,677.35 |
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 $363.08 Median $1,778.28 Typical High $3,467.37 | Professional | None | $363.08 | $1,778.28 | $3,467.37 |
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 $204.17 Median $467.74 Typical High $1,071.52 | Professional | 52 · Reduced service | $204.17 | $467.74 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $190.55 Typical High $426.58 | Professional | 53 · Discontinued | $83.18 | $190.55 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $707.95 Typical High $1,621.81 | Professional | 54 · Surgery only | $309.03 | $707.95 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $141.25 Typical High $323.59 | Professional | 55 · Aftercare only | $61.66 | $141.25 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $95.50 Typical High $213.80 | Professional | 56 · Pre-op care only | $41.69 | $95.50 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $660.69 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $288.40 | $660.69 | $1,513.56 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,000.00 Median $12,302.69 Typical High $18,197.01 | Facility | 50 · Both sides | $10,000.00 | $12,302.69 | $18,197.01 |
Where Utah sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 40th of 51
$1,202
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.