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 $51.29 Median $72.44 Typical High $4,570.88 | Facility | None | $51.29 | $72.44 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $77.62 | Professional | None | $51.29 | $70.79 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $66.07 Typical High $67.61 | Facility | None | $63.10 | $66.07 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $109.65 | Professional | None | $63.10 | $89.13 | $109.65 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | None | $70.79 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $102.33 | Professional | None | $54.95 | $87.10 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $64.57 | Professional | None | $54.95 | $58.88 | $64.57 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $47.86 Median $100.00 Typical High $144.54 | Professional | None | $47.86 | $100.00 | $144.54 |
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 $48.98 Median $70.79 Typical High $112.20 | Professional | None | $48.98 | $70.79 | $112.20 |
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 $25.70 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $25.70 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $10.23 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $51.29 Typical High $58.88 | Professional | 54 · Surgery only | $38.90 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.23 Typical High $11.75 | Professional | 55 · Aftercare only | $7.76 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.13 | $6.92 | $7.76 |
Where Utah sits
The same service costs 3.4 times more in Alaska than in New York. 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· 29th of 51
$81.28
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.