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 $134.90 Median $2,951.21 Typical High $4,570.88 | Facility | None | $134.90 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $234.42 | Professional | None | $123.03 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $162.18 | Facility | None | $154.88 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $309.03 | Professional | None | $141.25 | $208.93 | $309.03 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $165.96 | Professional | None | $100.00 | $128.82 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,445.44 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $288.40 | Professional | None | $158.49 | $229.09 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $338.84 | Professional | None | $141.25 | $229.09 | $338.84 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $316.23 | Professional | None | $117.49 | $181.97 | $316.23 |
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 $67.61 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $67.61 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $26.92 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $131.83 Typical High $154.88 | Professional | 54 · Surgery only | $100.00 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.30 Typical High $30.90 | Professional | 55 · Aftercare only | $20.42 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.49 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $123.03 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $93.33 | $123.03 | $144.54 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,698.24 Median $2,187.76 Typical High $3,162.28 | Facility | 50 · Both sides | $1,698.24 | $2,187.76 | $3,162.28 |
Where Utah sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$155
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.