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 $151.36 Median $2,951.21 Typical High $4,570.88 | Facility | None | $151.36 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $165.96 | Professional | None | $151.36 | $158.49 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $112.20 Typical High $114.82 | Facility | None | $107.15 | $112.20 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $245.47 | Professional | None | $131.83 | $177.83 | $245.47 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $162.18 | Professional | None | $74.13 | $117.49 | $162.18 |
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 $186.21 Median $208.93 Typical High $234.42 | Professional | None | $186.21 | $208.93 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $97.72 Median $204.17 Typical High $281.84 | Professional | None | $97.72 | $204.17 | $281.84 |
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 $123.03 Median $151.36 Typical High $257.04 | Professional | None | $123.03 | $151.36 | $257.04 |
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 $75.86 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $107.15 | $109.65 | $109.65 |
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 4.6 times more in Alaska than in Florida. 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
$141
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.