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 $117.49 Median $2,951.21 Typical High $4,570.88 | Facility | None | $117.49 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $147.91 | Professional | None | $117.49 | $128.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $107.15 | Facility | None | $102.33 | $104.71 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $190.55 | Professional | None | $107.15 | $144.54 | $190.55 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $128.82 | Professional | None | $74.13 | $97.72 | $128.82 |
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 $147.91 Median $173.78 Typical High $194.98 | Professional | None | $147.91 | $173.78 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $234.42 | Professional | None | $85.11 | $165.96 | $234.42 |
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 $97.72 Median $120.23 Typical High $190.55 | Professional | None | $97.72 | $120.23 | $190.55 |
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 $58.88 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $23.44 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $17.38 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $81.28 | $89.13 | $89.13 |
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 4.4 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
$115
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.