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 $26.92 Median $2,951.21 Typical High $4,570.88 | Facility | None | $26.92 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $39.81 Typical High $53.70 | Professional | None | $23.99 | $39.81 | $53.70 |
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 $34.67 Median $50.12 Typical High $61.66 | Professional | None | $34.67 | $50.12 | $61.66 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $69.18 | Professional | None | $47.86 | $56.23 | $69.18 |
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 $25.12 Median $42.66 Typical High $56.23 | Professional | None | $25.12 | $42.66 | $56.23 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Select Health Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $32.36 | Professional | None | $25.70 | $28.18 | $32.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $25.70 Median $53.70 Typical High $74.13 | Professional | None | $25.70 | $53.70 | $74.13 |
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 $23.44 Median $38.90 Typical High $63.10 | Professional | None | $23.44 | $38.90 | $63.10 |
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 $12.02 Median $18.20 Typical High $21.88 | Professional | 52 · Reduced service | $12.02 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $7.24 Typical High $8.71 | Professional | 53 · Discontinued | $4.79 | $7.24 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $27.54 Typical High $32.36 | Professional | 54 · Surgery only | $18.20 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $5.50 Typical High $6.46 | Professional | 55 · Aftercare only | $3.63 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $3.63 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.40 | $3.63 | $4.37 |
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· 18th of 51
$48.98
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.