How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,000 to $9,550Professionalmedian $550 · 10th to 90th $56 to $1,047
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 $1,000.00 Median $3,162.28 Typical High $4,570.88 | Facility | None | $1,000.00 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,148.15 | Professional | None | $812.83 | $1,000.00 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,778.28 | Facility | None | $1,698.24 | $1,737.80 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,548.82 | Professional | None | $954.99 | $1,047.13 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $524.81 Typical High $707.95 | Professional | None | $54.95 | $524.81 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,230.27 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,621.81 | Professional | None | $616.60 | $1,202.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $13,803.84 | Facility | None | $1,698.24 | $8,912.51 | $13,803.84 |
United Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,737.80 | Professional | None | $776.25 | $933.25 | $1,737.80 |
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 $426.58 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $691.83 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $10,000.00 Typical High $14,454.40 | Facility | 50 · Both sides | $7,413.10 | $10,000.00 | $14,454.40 |
Where Utah sits
The same service costs 6.9 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
$562
OK $3,890UT $562
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.