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 $100.00 Median $2,951.21 Typical High $4,570.88 | Facility | None | $100.00 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $257.04 | Professional | None | $83.18 | $158.49 | $257.04 |
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 $89.13 Median $181.97 Typical High $213.80 | Professional | None | $89.13 | $181.97 | $213.80 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $165.96 | Professional | None | $120.23 | $141.25 | $165.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $239.88 | Professional | None | $104.71 | $190.55 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $154.88 | Professional | None | $89.13 | $134.90 | $154.88 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $478.63 | Professional | None | $112.20 | $218.78 | $478.63 |
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 $72.44 Median $144.54 Typical High $257.04 | Professional | None | $72.44 | $144.54 | $257.04 |
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 $50.12 Median $75.86 Typical High $128.82 | Professional | 52 · Reduced service | $50.12 | $75.86 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $30.20 Typical High $51.29 | Professional | 53 · Discontinued | $19.95 | $30.20 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $114.82 Typical High $194.98 | Professional | 54 · Surgery only | $75.86 | $114.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.91 Typical High $38.90 | Professional | 55 · Aftercare only | $15.14 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.14 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.00 | $15.14 | $25.70 |
Where Utah sits
The same service costs 3.9 times more in Alaska 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· 41st of 51
$145
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.