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 $91.20 Median $2,951.21 Typical High $4,570.88 | Facility | None | $91.20 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $239.88 Typical High $288.40 | Professional | None | $91.20 | $239.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $426.58 | Professional | None | $112.20 | $263.03 | $426.58 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $245.47 | Professional | None | $165.96 | $199.53 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $371.54 | Professional | None | $89.13 | $154.88 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $102.33 Median $295.12 Typical High $707.95 | Professional | None | $102.33 | $295.12 | $707.95 |
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 $81.28 Median $218.78 Typical High $501.19 | Professional | None | $81.28 | $218.78 | $501.19 |
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 $45.71 Median $61.66 Typical High $144.54 | Professional | 52 · Reduced service | $45.71 | $61.66 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.12 Typical High $57.54 | Professional | 53 · Discontinued | $18.20 | $25.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $93.33 Typical High $218.78 | Professional | 54 · Surgery only | $69.18 | $93.33 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.62 Typical High $43.65 | Professional | 55 · Aftercare only | $13.80 | $18.62 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $28.84 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $28.84 |
Where Utah sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 39th of 51
$219
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.