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 $107.15 Median $2,884.03 Typical High $4,786.30 | Facility | None | $107.15 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $194.98 | Professional | None | $91.20 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $114.82 Typical High $114.82 | Facility | None | $107.15 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $218.78 | Professional | None | $141.25 | $186.21 | $218.78 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $173.78 | Professional | None | $120.23 | $141.25 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $5,495.41 | Facility | None | $3,019.95 | $3,801.89 | $5,495.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $199.53 | Professional | None | $97.72 | $162.18 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | None | $100.00 | $109.65 | $125.89 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $263.03 | Professional | None | $102.33 | $190.55 | $263.03 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $223.87 | Professional | None | $91.20 | $147.91 | $223.87 |
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 $46.77 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $46.77 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $18.62 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $70.79 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $14.13 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.33 | $13.80 | $15.85 |
Where Utah sits
The same service costs 3.2 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· 34th of 51
$155
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.