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 $4.68 Median $2,951.21 Typical High $4,570.88 | Facility | None | $4.68 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $6.03 Typical High $8.13 | Professional | None | $3.72 | $6.03 | $8.13 |
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 $5.62 Median $8.13 Typical High $10.00 | Professional | None | $5.62 | $8.13 | $10.00 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $60.26 | Professional | None | $8.51 | $9.55 | $60.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $2.14 Median $5.37 Typical High $8.32 | Professional | None | $2.14 | $5.37 | $8.32 |
Select Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Select Health Setting Professional Modifier None Typical Low $2.14 Median $2.29 Typical High $2.45 | Professional | None | $2.14 | $2.29 | $2.45 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $2.19 Median $7.59 Typical High $11.22 | Professional | None | $2.19 | $7.59 | $11.22 |
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 $2.00 Median $5.50 Typical High $9.12 | Professional | None | $2.00 | $5.50 | $9.12 |
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 $1.58 Median $2.45 Typical High $3.72 | Professional | 52 · Reduced service | $1.58 | $2.45 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.98 Typical High $1.48 | Professional | 53 · Discontinued | $0.65 | $0.98 | $1.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $3.72 Typical High $5.62 | Professional | 54 · Surgery only | $2.45 | $3.72 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.74 Typical High $1.12 | Professional | 55 · Aftercare only | $0.49 | $0.74 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.49 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.33 | $0.49 | $0.74 |
Where Utah sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 30th of 51
$6.46
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.