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 $144.54 Median $3,162.28 Typical High $8,511.38 | Facility | None | $144.54 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $257.04 | Professional | None | $144.54 | $223.87 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,819.70 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $426.58 | Professional | None | $165.96 | $269.15 | $426.58 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $281.84 | Professional | None | $190.55 | $229.09 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $11,481.54 | Facility | None | $5,888.44 | $7,943.28 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $446.68 | Professional | None | $177.83 | $323.59 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $117.49 Median $346.74 Typical High $562.34 | Professional | None | $117.49 | $346.74 | $562.34 |
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 $138.04 Median $245.47 Typical High $478.63 | Professional | None | $138.04 | $245.47 | $478.63 |
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 $72.44 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $72.44 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $28.84 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $25.12 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $11,748.98 Typical High $16,982.44 | Facility | 50 · Both sides | $8,709.64 | $11,748.98 | $16,982.44 |
Where Utah sits
The same service costs 5.8 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· 44th of 51
$251
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.