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 $2,951.21 Typical High $4,570.88 | Facility | None | $117.49 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $331.13 | Professional | None | $79.43 | $194.98 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $269.15 Typical High $446.68 | Professional | None | $104.71 | $269.15 | $446.68 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $309.03 | Professional | None | $208.93 | $251.19 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $489.78 | Professional | None | $102.33 | $223.87 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $446.68 | Professional | None | $81.28 | $147.91 | $446.68 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $95.50 Median $371.54 Typical High $630.96 | Professional | None | $95.50 | $371.54 | $630.96 |
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 $81.28 Median $218.78 Typical High $602.56 | Professional | None | $81.28 | $218.78 | $602.56 |
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 $58.88 Median $85.11 Typical High $162.18 | Professional | 52 · Reduced service | $58.88 | $85.11 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $64.57 | Professional | 53 · Discontinued | $23.44 | $33.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $239.88 | Professional | 54 · Surgery only | $87.10 | $128.82 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $47.86 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $32.36 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $32.36 |
Where Utah sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 24th of 51
$257
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.