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 $288.40 Median $3,162.28 Typical High $8,709.64 | Facility | None | $288.40 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $346.74 | Professional | None | $288.40 | $316.23 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $223.87 Typical High $229.09 | Facility | None | $208.93 | $223.87 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $416.87 | Professional | None | $239.88 | $323.59 | $416.87 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $165.96 Typical High $281.84 | Professional | None | $27.54 | $165.96 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,621.81 | Facility | None | $912.01 | $1,122.02 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $446.68 | Professional | None | $309.03 | $380.19 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $549.54 | Professional | None | $204.17 | $354.81 | $549.54 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $457.09 | Professional | None | $229.09 | $295.12 | $457.09 |
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 $144.54 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $239.88 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,454.71 | Facility | 50 · Both sides | $1,348.96 | $1,698.24 | $2,454.71 |
Where Utah sits
The same service costs 5.2 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
$191
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.