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 $275.42 Median $2,951.21 Typical High $4,570.88 | Facility | None | $275.42 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $436.52 | Professional | None | $275.42 | $389.05 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $208.93 | Facility | None | $199.53 | $204.17 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $489.78 | Professional | None | $316.23 | $407.38 | $489.78 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $295.12 Typical High $398.11 | Professional | None | $26.92 | $295.12 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $616.60 Typical High $891.25 | Facility | None | $478.63 | $616.60 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $630.96 | Professional | None | $316.23 | $537.03 | $630.96 |
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 $199.53 Median $380.19 Typical High $794.33 | Professional | None | $199.53 | $380.19 | $794.33 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $630.96 | Professional | None | $234.42 | $371.54 | $630.96 |
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 $134.90 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $134.90 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $54.95 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $302.00 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $707.95 Median $933.25 Typical High $1,348.96 | Facility | 50 · Both sides | $707.95 | $933.25 | $1,348.96 |
Where Utah sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 47th of 51
$316
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.