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 $144.54 Median $2,884.03 Typical High $4,786.30 | Facility | None | $144.54 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $275.42 | Professional | None | $144.54 | $263.03 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $645.65 | Facility | None | $616.60 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $295.12 | Professional | None | $162.18 | $223.87 | $295.12 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $165.96 Typical High $251.19 | Professional | None | $26.30 | $165.96 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,548.82 | $1,995.26 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $389.05 | Professional | None | $169.82 | $309.03 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $169.82 Median $380.19 Typical High $676.08 | Professional | None | $169.82 | $380.19 | $676.08 |
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 $123.03 Median $229.09 Typical High $389.05 | Professional | None | $123.03 | $229.09 | $389.05 |
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 $72.44 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $72.44 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $28.84 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $107.15 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $21.38 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $186.21 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $100.00 | $186.21 | $186.21 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $3,019.95 Typical High $4,365.16 | Facility | 50 · Both sides | $2,344.23 | $3,019.95 | $4,365.16 |
Where Utah sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$186
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.