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 $26.30 Median $2,951.21 Typical High $4,570.88 | Facility | None | $26.30 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $38.02 | Professional | None | $24.55 | $29.51 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $48.98 | Professional | None | $34.67 | $42.66 | $48.98 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $60.26 | Professional | None | $40.74 | $58.88 | $60.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $26.30 Median $34.67 Typical High $42.66 | Professional | None | $26.30 | $34.67 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Select Health Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $33.11 | Professional | None | $26.30 | $28.84 | $33.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $54.95 | Professional | None | $23.44 | $39.81 | $54.95 |
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 $24.55 Median $33.11 Typical High $48.98 | Professional | None | $24.55 | $33.11 | $48.98 |
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 $12.88 Median $14.45 Typical High $17.38 | Professional | 52 · Reduced service | $12.88 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.75 Typical High $6.92 | Professional | 53 · Discontinued | $5.13 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $21.88 Typical High $26.30 | Professional | 54 · Surgery only | $19.05 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.37 Typical High $5.25 | Professional | 55 · Aftercare only | $3.80 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.88 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.51 | $2.88 | $3.47 |
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
$34.67
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.