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 $194.98 Median $2,951.21 Typical High $4,570.88 | Facility | None | $194.98 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | None | $162.18 | $194.98 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $213.80 | Facility | None | $199.53 | $208.93 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $269.15 | Professional | None | $151.36 | $218.78 | $269.15 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $162.18 | Professional | None | $97.72 | $128.82 | $162.18 |
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 $158.49 Median $199.53 Typical High $234.42 | Professional | None | $158.49 | $199.53 | $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 $134.90 Median $208.93 Typical High $288.40 | Professional | None | $134.90 | $208.93 | $288.40 |
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 $125.89 Median $173.78 Typical High $269.15 | Professional | None | $125.89 | $173.78 | $269.15 |
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 $97.72 Median $97.72 Typical High $120.23 | Professional | 52 · Reduced service | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $169.82 |
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 3.5 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
$148
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.