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 $117.49 Median $3,162.28 Typical High $4,570.88 | Facility | None | $117.49 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $162.18 | Professional | None | $91.20 | $117.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $190.55 | Professional | None | $128.82 | $144.54 | $190.55 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $102.33 | Professional | None | $72.44 | $85.11 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Facility | None | $616.60 | $812.83 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $177.83 | Professional | None | $112.20 | $128.82 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $194.98 | Professional | None | $85.11 | $112.20 | $194.98 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $204.17 | Professional | None | $93.33 | $151.36 | $204.17 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $5,128.61 | Facility | None | $1,698.24 | $4,466.84 | $5,128.61 |
United Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $229.09 | Professional | None | $102.33 | $125.89 | $229.09 |
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 $57.54 Typical High $60.26 | Professional | 52 · Reduced service | $46.77 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $18.62 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $87.10 Typical High $91.20 | Professional | 54 · Surgery only | $70.79 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.33 | $11.75 | $12.02 |
Where Utah sits
The same service costs 3.5 times more in Wisconsin 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· 50th of 51
$97.72
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.