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 $2,884.03 Typical High $4,786.30 | Facility | None | $257.04 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $380.19 | Professional | None | $257.04 | $371.54 | $380.19 |
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 $281.84 Median $371.54 Typical High $426.58 | Professional | None | $281.84 | $371.54 | $426.58 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $263.03 Typical High $346.74 | Professional | None | $26.92 | $263.03 | $346.74 |
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 $295.12 Median $457.09 Typical High $537.03 | Professional | None | $295.12 | $457.09 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $354.81 Typical High $676.08 | Professional | None | $186.21 | $354.81 | $676.08 |
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 $218.78 Median $331.13 Typical High $537.03 | Professional | None | $218.78 | $331.13 | $537.03 |
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 $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $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 3.9 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
$282
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.