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 $107.15 Median $123.03 Typical High $4,570.88 | Facility | None | $107.15 | $123.03 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | None | $97.72 | $107.15 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $141.25 | Professional | None | $89.13 | $120.23 | $141.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $100.00 | Professional | None | $70.79 | $83.18 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Facility | None | $616.60 | $812.83 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $138.04 | Professional | None | $97.72 | $117.49 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $165.96 | Professional | None | $97.72 | $128.82 | $165.96 |
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 $75.86 Median $95.50 Typical High $154.88 | Professional | None | $75.86 | $95.50 | $154.88 |
6 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 $53.70 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $53.70 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $24.55 | Professional | 53 · Discontinued | $21.38 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $75.86 | $75.86 | $87.10 |
Where Utah sits
The same service costs 4.2 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· 42nd of 51
$100
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.