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 $281.84 Median $2,951.21 Typical High $4,570.88 | Facility | None | $281.84 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $331.13 | Professional | None | $263.03 | $309.03 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $234.42 Typical High $239.88 | Facility | None | $223.87 | $234.42 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $512.86 | Professional | None | $239.88 | $467.74 | $512.86 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $213.80 Typical High $281.84 | Professional | None | $26.92 | $213.80 | $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 $288.40 Median $371.54 Typical High $436.52 | Professional | None | $288.40 | $371.54 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $537.03 | Professional | None | $190.55 | $338.84 | $537.03 |
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 $218.78 Median $309.03 Typical High $501.19 | Professional | None | $218.78 | $309.03 | $501.19 |
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 $141.25 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $56.23 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $229.09 |
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 4.2 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
$229
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.