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 $74.13 Median $2,951.21 Typical High $4,570.88 | Facility | None | $74.13 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $147.91 | Professional | None | $57.54 | $97.72 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Facility | None | $72.44 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $186.21 | Professional | None | $77.62 | $117.49 | $186.21 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $1,202.26 | Facility | None | $630.96 | $831.76 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $169.82 | Professional | None | $57.54 | $107.15 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $218.78 | Professional | None | $67.61 | $120.23 | $218.78 |
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 $56.23 Median $97.72 Typical High $173.78 | Professional | None | $56.23 | $97.72 | $173.78 |
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 $34.67 Median $41.69 Typical High $74.13 | Professional | 52 · Reduced service | $34.67 | $41.69 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $29.51 | Professional | 53 · Discontinued | $13.80 | $16.98 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $112.20 | Professional | 54 · Surgery only | $51.29 | $63.10 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $22.39 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $14.79 |
Where Utah sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 49th 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.