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 $131.83 Median $3,162.28 Typical High $4,570.88 | Facility | None | $131.83 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $134.90 | Professional | None | $125.89 | $131.83 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $371.54 Typical High $380.19 | Facility | None | $354.81 | $371.54 | $380.19 |
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 $1,047.13 Median $1,380.38 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,380.38 | $1,995.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $371.54 Typical High $676.08 | Professional | None | $165.96 | $371.54 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $3,890.45 | Professional | None | $398.11 | $630.96 | $3,890.45 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $309.03 | Professional | None | $144.54 | $169.82 | $309.03 |
4 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 $63.10 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $63.10 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $25.12 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $13.49 |
Where Utah sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 16th of 51
$372
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.