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 $398.11 Median $3,162.28 Typical High $4,570.88 | Facility | None | $398.11 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $398.11 Typical High $398.11 | Professional | None | $64.57 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $67.61 | Facility | None | $61.66 | $66.07 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | None | $70.79 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $112.20 | Professional | None | $63.10 | $95.50 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $95.50 | Professional | None | $69.18 | $83.18 | $95.50 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $169.82 | Professional | None | $64.57 | $112.20 | $169.82 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $151.36 | Professional | None | $66.07 | $97.72 | $151.36 |
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 $32.36 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $32.36 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $12.88 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $47.86 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $9.55 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $6.46 | $39.81 | $39.81 |
Where Utah sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 44th of 51
$95.50
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.