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 $281.84 Median $3,162.28 Typical High $8,511.38 | Facility | None | $281.84 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $489.78 | Professional | None | $281.84 | $380.19 | $489.78 |
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 $316.23 Median $416.87 Typical High $524.81 | Professional | None | $316.23 | $416.87 | $524.81 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $245.47 Typical High $416.87 | Professional | None | $27.54 | $245.47 | $416.87 |
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 $389.05 Median $588.84 Typical High $691.83 | Professional | None | $389.05 | $588.84 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $1,258.93 | Professional | None | $380.19 | $676.08 | $1,258.93 |
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 $251.19 Median $389.05 Typical High $676.08 | Professional | None | $251.19 | $389.05 | $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 $141.25 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $141.25 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $208.93 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $194.98 | $263.03 | $263.03 |
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 5.9 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
$288
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.