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 $257.04 Median $3,162.28 Typical High $8,511.38 | Facility | None | $257.04 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $346.74 | Professional | None | $257.04 | $323.59 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $295.12 Typical High $302.00 | Facility | None | $281.84 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $389.05 | Professional | None | $223.87 | $295.12 | $389.05 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $194.98 Typical High $281.84 | Professional | None | $26.92 | $194.98 | $281.84 |
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 $245.47 Median $380.19 Typical High $446.68 | Professional | None | $245.47 | $380.19 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $549.54 | Professional | None | $169.82 | $323.59 | $549.54 |
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 $186.21 Median $281.84 Typical High $489.78 | Professional | None | $186.21 | $281.84 | $489.78 |
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 $128.82 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $128.82 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $194.98 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $181.97 | $229.09 | $239.88 |
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 4.3 times more in Wyoming 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.