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 $79.43 Median $3,162.28 Typical High $6,025.60 | Facility | None | $79.43 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | None | $69.18 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $489.78 | Facility | None | $457.09 | $478.63 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $131.83 | Professional | None | $44.67 | $60.26 | $131.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Facility | None | $977.24 | $1,258.93 | $1,819.70 |
Regence BlueShield Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $97.72 | Professional | None | $83.18 | $93.33 | $97.72 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $5,011.87 | Professional | None | $64.57 | $67.61 | $5,011.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $120.23 | Professional | None | $87.10 | $102.33 | $120.23 |
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 $66.07 Median $75.86 Typical High $131.83 | Professional | None | $66.07 | $75.86 | $131.83 |
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 $36.31 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | 54 · Surgery only | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.96 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.24 | $7.94 | $7.94 |
Where Utah sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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
$93.33
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.