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 $31.62 Median $2,951.21 Typical High $4,570.88 | Facility | None | $31.62 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $63.10 | Professional | None | $29.51 | $50.12 | $63.10 |
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 $38.02 Median $70.79 Typical High $83.18 | Professional | None | $38.02 | $70.79 | $83.18 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $35.48 | Professional | None | $23.44 | $28.18 | $35.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $75.86 | Professional | None | $30.20 | $54.95 | $75.86 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $35.48 | Professional | None | $30.20 | $32.36 | $35.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $26.92 Median $74.13 Typical High $107.15 | Professional | None | $26.92 | $74.13 | $107.15 |
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 $28.18 Median $51.29 Typical High $87.10 | Professional | None | $28.18 | $51.29 | $87.10 |
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 $14.79 Median $21.88 Typical High $30.90 | Professional | 52 · Reduced service | $14.79 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $8.91 Typical High $12.59 | Professional | 53 · Discontinued | $5.89 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $33.11 Typical High $46.77 | Professional | 54 · Surgery only | $21.88 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $6.61 Typical High $9.33 | Professional | 55 · Aftercare only | $4.37 | $6.61 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $2.95 | $4.37 | $6.31 |
Where Utah sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 50th of 51
$38.02
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.