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 $66.07 Median $2,951.21 Typical High $4,570.88 | Facility | None | $66.07 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $177.83 | Professional | None | $60.26 | $107.15 | $177.83 |
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 $77.62 Median $123.03 Typical High $245.47 | Professional | None | $77.62 | $123.03 | $245.47 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $173.78 | Professional | None | $117.49 | $141.25 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $389.05 | Facility | None | $204.17 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $229.09 | Professional | None | $70.79 | $125.89 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $75.86 Median $154.88 Typical High $309.03 | Professional | None | $75.86 | $154.88 | $309.03 |
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 $102.33 Typical High $257.04 | Professional | None | $57.54 | $102.33 | $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 $33.11 Median $44.67 Typical High $74.13 | Professional | 52 · Reduced service | $33.11 | $44.67 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.78 Typical High $29.51 | Professional | 53 · Discontinued | $13.18 | $17.78 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $67.61 Typical High $109.65 | Professional | 54 · Surgery only | $50.12 | $67.61 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.49 Typical High $21.88 | Professional | 55 · Aftercare only | $10.00 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.61 | $8.91 | $14.79 |
Where Utah sits
The same service costs 4.0 times more in Alaska 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· 25th of 51
$135
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.