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 $407.38 Median $4,570.88 Typical High $9,772.37 | Facility | None | $407.38 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $407.38 | Professional | None | $309.03 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $416.87 | Professional | None | $323.59 | $354.81 | $416.87 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | None | $169.82 | $194.98 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $398.11 | Professional | None | $338.84 | $363.08 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $501.19 | Professional | None | $288.40 | $426.58 | $501.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $645.65 | Professional | None | $239.88 | $426.58 | $645.65 |
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 $239.88 Median $281.84 Typical High $478.63 | Professional | None | $239.88 | $281.84 | $478.63 |
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 $154.88 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $154.88 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.90 | $40.74 | $40.74 |
Where Utah sits
The same service costs 4.8 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
$229
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.