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 $354.81 Median $2,884.03 Typical High $4,786.30 | Facility | None | $354.81 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
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 $302.00 Median $407.38 Typical High $575.44 | Professional | None | $302.00 | $407.38 | $575.44 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $218.78 Typical High $316.23 | Professional | None | $27.54 | $218.78 | $316.23 |
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 $436.52 Median $512.86 Typical High $562.34 | Professional | None | $436.52 | $512.86 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $691.83 | Professional | None | $257.04 | $501.19 | $691.83 |
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 $302.00 Median $363.08 Typical High $588.84 | Professional | None | $302.00 | $363.08 | $588.84 |
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 $177.83 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $269.15 |
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 5.6 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
$251
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.