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 $1,479.11 Median $4,570.88 Typical High $9,772.37 | Facility | None | $1,479.11 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $8,912.51 Typical High $9,120.11 | Facility | None | $8,511.38 | $8,912.51 | $9,120.11 |
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 $16,218.10 Median $21,379.62 Typical High $30,902.95 | Facility | None | $16,218.10 | $21,379.62 | $30,902.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,621.81 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,187.76 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,370.32 Typical High $15,848.93 | Facility | None | $2,398.83 | $5,370.32 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,778.28 | $3,162.28 |
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 $741.31 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $158.49 |
Where Utah sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 42nd of 51
$2,089
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.