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 $1,288.25 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,288.25 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,288.25 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $2,344.23 | Facility | None | $2,187.76 | $2,290.87 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,479.11 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $2,238.72 | Professional | None | $44.67 | $60.26 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $7,585.78 Typical High $10,964.78 | Facility | None | $6,025.60 | $7,585.78 | $10,964.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,513.56 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,128.61 | Professional | None | $5,011.87 | $5,011.87 | $5,128.61 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,659.59 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,288.25 | $2,187.76 |
6 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 $588.84 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $128.82 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $9,120.11 Median $11,220.18 Typical High $16,595.87 | Facility | 50 · Both sides | $9,120.11 | $11,220.18 | $16,595.87 |
Where Utah sits
The same service costs 4.8 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· 27th of 51
$1,479
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.