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 $977.24 Median $3,162.28 Typical High $4,570.88 | Facility | None | $977.24 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $977.24 | Professional | None | $691.83 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,000.00 | Professional | None | $794.33 | $891.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $602.56 | Professional | None | $436.52 | $501.19 | $602.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,023.29 | Professional | None | $870.96 | $912.01 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,258.93 | Professional | None | $724.44 | $1,071.52 | $1,258.93 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,621.81 | Professional | None | $602.56 | $977.24 | $1,621.81 |
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 $588.84 Median $676.08 Typical High $1,174.90 | Professional | None | $588.84 | $676.08 | $1,174.90 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $97.72 |
Where Utah sits
The same service costs 4.7 times more in Alaska than in Utah. 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· 51st of 51
$589
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.