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 $162.18 Median $2,951.21 Typical High $4,570.88 | Facility | None | $162.18 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $263.03 | Professional | None | $158.49 | $223.87 | $263.03 |
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 $169.82 Median $263.03 Typical High $389.05 | Professional | None | $169.82 | $263.03 | $389.05 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $138.04 Typical High $190.55 | Professional | None | $26.30 | $138.04 | $190.55 |
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 $181.97 Median $275.42 Typical High $363.08 | Professional | None | $181.97 | $275.42 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $407.38 | Professional | None | $169.82 | $229.09 | $407.38 |
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 $141.25 Median $229.09 Typical High $398.11 | Professional | None | $141.25 | $229.09 | $398.11 |
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 $81.28 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $81.28 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $123.03 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $114.82 | $154.88 | $181.97 |
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 4.6 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
$162
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.