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 $67.61 Median $125.89 Typical High $4,570.88 | Facility | None | $67.61 | $125.89 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $128.82 | Professional | None | $67.61 | $107.15 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $102.33 | Facility | None | $93.33 | $100.00 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $186.21 | Professional | None | $72.44 | $125.89 | $186.21 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,513.56 | Facility | None | $831.76 | $1,071.52 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $177.83 | Professional | None | $75.86 | $128.82 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $46.77 Median $131.83 Typical High $213.80 | Professional | None | $46.77 | $131.83 | $213.80 |
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 $57.54 Median $104.71 Typical High $190.55 | Professional | None | $57.54 | $104.71 | $190.55 |
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 $33.88 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $33.88 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $13.80 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $77.62 Typical High $93.33 | Professional | 54 · Surgery only | $51.29 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $10.23 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.23 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.76 | $10.23 | $12.59 |
Where Utah sits
The same service costs 3.9 times more in Wisconsin 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· 47th of 51
$97.72
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.