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 $74.13 Median $2,951.21 Typical High $4,570.88 | Facility | None | $74.13 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $223.87 | Professional | None | $63.10 | $138.04 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $173.78 Typical High $218.78 | Professional | None | $66.07 | $173.78 | $218.78 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $199.53 | Professional | None | $141.25 | $169.82 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $302.00 | Professional | None | $64.57 | $165.96 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $93.33 | Professional | None | $54.95 | $79.43 | $93.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $66.07 Median $245.47 Typical High $398.11 | Professional | None | $66.07 | $245.47 | $398.11 |
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 $48.98 Median $134.90 Typical High $288.40 | Professional | None | $48.98 | $134.90 | $288.40 |
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 $37.15 Median $52.48 Typical High $112.20 | Professional | 52 · Reduced service | $37.15 | $52.48 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $21.38 Typical High $44.67 | Professional | 53 · Discontinued | $14.79 | $21.38 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $79.43 Typical High $165.96 | Professional | 54 · Surgery only | $56.23 | $79.43 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.85 Typical High $33.11 | Professional | 55 · Aftercare only | $11.22 | $15.85 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $22.39 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $22.39 |
Where Utah sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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
$166
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.