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 $8.51 Median $21.38 Typical High $4,570.88 | Facility | None | $8.51 | $21.38 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $12.88 Typical High $23.44 | Professional | None | $7.59 | $12.88 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $17.38 Typical High $24.55 | Professional | None | $10.72 | $17.38 | $24.55 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $23.44 Typical High $60.26 | Professional | None | $12.02 | $23.44 | $60.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $177.83 | Facility | None | $97.72 | $123.03 | $177.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $7.76 Median $13.80 Typical High $17.78 | Professional | None | $7.76 | $13.80 | $17.78 |
Select Health Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Select Health Setting Professional Modifier None Typical Low $7.94 Median $8.91 Typical High $10.00 | Professional | None | $7.94 | $8.91 | $10.00 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $7.94 Median $16.98 Typical High $25.70 | Professional | None | $7.94 | $16.98 | $25.70 |
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 $7.24 Median $12.30 Typical High $20.89 | Professional | None | $7.24 | $12.30 | $20.89 |
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 $3.80 Median $5.75 Typical High $10.72 | Professional | 52 · Reduced service | $3.80 | $5.75 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $2.29 Typical High $4.37 | Professional | 53 · Discontinued | $1.51 | $2.29 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.62 Median $8.71 Typical High $16.22 | Professional | 54 · Surgery only | $5.62 | $8.71 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.74 Typical High $3.24 | Professional | 55 · Aftercare only | $1.12 | $1.74 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.15 Typical High $2.14 | Professional | 56 · Pre-op care only | $0.76 | $1.15 | $2.14 |
Where Utah sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 31st of 51
$14.45
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.