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 $1,949.84 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,949.84 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,041.74 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $933.25 Typical High $1,288.25 | Professional | None | $85.11 | $933.25 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,398.83 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,258.93 Median $2,398.83 Typical High $5,370.32 | Professional | None | $1,258.93 | $2,398.83 | $5,370.32 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,862.09 | $3,388.44 |
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 $812.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $812.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,348.96 | $1,348.96 |
Where Utah sits
The same service costs 7.8 times more in Alaska than in Texas. 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
$1,023
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.