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 $645.65 Median $3,162.28 Typical High $9,332.54 | Facility | None | $645.65 | $3,162.28 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $645.65 Typical High $724.44 | Professional | None | $295.12 | $645.65 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $218.78 Typical High $223.87 | Facility | None | $204.17 | $218.78 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $812.83 | Professional | None | $446.68 | $741.31 | $812.83 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $190.55 Typical High $257.04 | Professional | None | $26.30 | $190.55 | $257.04 |
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 $338.84 Median $389.05 Typical High $436.52 | Professional | None | $338.84 | $389.05 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $524.81 | Professional | None | $208.93 | $398.11 | $524.81 |
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 $257.04 Median $398.11 Typical High $676.08 | Professional | None | $257.04 | $398.11 | $676.08 |
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 $316.23 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $501.19 |
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 5.0 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.