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 $316.23 Median $3,162.28 Typical High $4,570.88 | Facility | None | $316.23 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $316.23 | Professional | None | $204.17 | $316.23 | $316.23 |
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 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $60.26 | Professional | None | $30.20 | $44.67 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,162.28 | $3,981.07 | $5,888.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $288.40 | Professional | None | $229.09 | $263.03 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $407.38 | Professional | None | $245.47 | $281.84 | $407.38 |
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 $199.53 Median $234.42 Typical High $426.58 | Professional | None | $199.53 | $234.42 | $426.58 |
5 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 $102.33 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $102.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $40.74 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $31.62 |
Where Utah sits
The same service costs 19.5 times more in Texas than in New York. 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· 37th of 51
$316
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.