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 $18.62 Median $48.98 Typical High $4,570.88 | Facility | None | $18.62 | $48.98 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $26.92 Typical High $48.98 | Professional | None | $17.38 | $26.92 | $48.98 |
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 $22.91 Median $38.90 Typical High $54.95 | Professional | None | $22.91 | $38.90 | $54.95 |
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 $17.78 Median $28.84 Typical High $37.15 | Professional | None | $17.78 | $28.84 | $37.15 |
Select Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Select Health Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $21.38 | Professional | None | $18.20 | $19.50 | $21.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $16.22 Median $36.31 Typical High $57.54 | Professional | None | $16.22 | $36.31 | $57.54 |
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 $16.22 Median $30.20 Typical High $58.88 | Professional | None | $16.22 | $30.20 | $58.88 |
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 $8.51 Median $13.49 Typical High $24.55 | Professional | 52 · Reduced service | $8.51 | $13.49 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $5.37 Typical High $9.77 | Professional | 53 · Discontinued | $3.47 | $5.37 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $19.95 Typical High $36.31 | Professional | 54 · Surgery only | $12.88 | $19.95 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $3.98 Typical High $7.41 | Professional | 55 · Aftercare only | $2.57 | $3.98 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.69 Typical High $4.90 | Professional | 56 · Pre-op care only | $1.74 | $2.69 | $4.90 |
Where Utah sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 40th of 51
$30.20
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.