How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,202 to $13,804Professionalmedian $631 · 10th to 90th $60 to $1,202
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 $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,258.93 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $588.84 Typical High $812.83 | Professional | None | $56.23 | $588.84 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,332.54 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,513.56 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $741.31 Median $1,479.11 Typical High $3,235.94 | Professional | None | $741.31 | $1,479.11 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,089.30 | Professional | None | $954.99 | $1,148.15 | $2,089.30 |
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 $512.86 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $831.76 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,197.01 Typical High $26,302.68 | Facility | 50 · Both sides | $13,803.84 | $18,197.01 | $26,302.68 |
Where Utah sits
The same service costs 7.2 times more in Oklahoma than in Utah. 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· 51st of 51
$646
OK $4,677UT $646
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.