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 $309.03 Median $2,884.03 Typical High $4,786.30 | Facility | None | $309.03 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $436.52 | Professional | None | $309.03 | $331.13 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $363.08 Typical High $371.54 | Facility | None | $346.74 | $363.08 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $501.19 | Professional | None | $275.42 | $371.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $190.55 Typical High $269.15 | Professional | None | $27.54 | $190.55 | $269.15 |
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 $389.05 Median $436.52 Typical High $489.78 | Professional | None | $389.05 | $436.52 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $223.87 Median $426.58 Typical High $588.84 | Professional | None | $223.87 | $426.58 | $588.84 |
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 $251.19 Median $309.03 Typical High $512.86 | Professional | None | $251.19 | $309.03 | $512.86 |
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 $154.88 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $245.47 | Professional | 54 · Surgery only | $218.78 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $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 5.8 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
$219
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.