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 $162.18 Median $2,884.03 Typical High $4,786.30 | Facility | None | $162.18 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $295.12 | Professional | None | $162.18 | $239.88 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $251.19 | Facility | None | $234.42 | $245.47 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $316.23 | Professional | None | $186.21 | $257.04 | $316.23 |
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 $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 $194.98 Median $338.84 Typical High $398.11 | Professional | None | $194.98 | $338.84 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $478.63 | Professional | None | $131.83 | $263.03 | $478.63 |
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 $141.25 Median $239.88 Typical High $407.38 | Professional | None | $141.25 | $239.88 | $407.38 |
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 $81.28 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $123.03 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $114.82 | $190.55 | $190.55 |
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 3.8 times more in Wyoming than in Kentucky. 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
$200
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.