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 $112.20 Median $2,951.21 Typical High $4,570.88 | Facility | None | $112.20 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $199.53 | Professional | None | $112.20 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,445.44 | $1,479.11 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $199.53 | Professional | None | $125.89 | $169.82 | $199.53 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $162.18 | Professional | None | $97.72 | $128.82 | $162.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $4,677.35 Typical High $6,760.83 | Facility | None | $3,801.89 | $4,677.35 | $6,760.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $257.04 | Professional | None | $138.04 | $218.78 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $87.10 Median $251.19 Typical High $1,479.11 | Professional | None | $87.10 | $251.19 | $1,479.11 |
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 $97.72 Median $147.91 Typical High $239.88 | Professional | None | $97.72 | $147.91 | $239.88 |
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 $54.95 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $22.39 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $77.62 | $114.82 | $114.82 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $5,623.41 Median $7,079.46 Typical High $10,232.93 | Facility | 50 · Both sides | $5,623.41 | $7,079.46 | $10,232.93 |
Where Utah sits
The same service costs 4.8 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· 50th of 51
$135
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.