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 $457.09 Median $3,162.28 Typical High $8,709.64 | Facility | None | $457.09 | $3,162.28 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $562.34 | Professional | None | $457.09 | $549.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,288.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $724.44 | Professional | None | $416.87 | $512.86 | $724.44 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $302.00 Typical High $457.09 | Professional | None | $56.23 | $302.00 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,630.78 Median $4,786.30 Typical High $6,918.31 | Facility | None | $3,630.78 | $4,786.30 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $794.33 | Professional | None | $549.54 | $676.08 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $1,288.25 | Professional | None | $446.68 | $741.31 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $794.33 | Professional | None | $389.05 | $501.19 | $794.33 |
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 $229.09 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $380.19 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $5,495.41 Median $7,244.36 Typical High $10,471.29 | Facility | 50 · Both sides | $5,495.41 | $7,244.36 | $10,471.29 |
Where Utah sits
The same service costs 6.5 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
$347
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.