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 $158.49 Median $2,884.03 Typical High $4,786.30 | Facility | None | $158.49 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $302.00 | Professional | None | $158.49 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $263.03 | Facility | None | $245.47 | $257.04 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $457.09 | Professional | None | $173.78 | $302.00 | $457.09 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $281.84 | Professional | None | $190.55 | $229.09 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,148.15 | Facility | None | $645.65 | $794.33 | $1,148.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $426.58 | Professional | None | $169.82 | $295.12 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $162.18 Median $323.59 Typical High $588.84 | Professional | None | $162.18 | $323.59 | $588.84 |
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 $134.90 Median $245.47 Typical High $467.74 | Professional | None | $134.90 | $245.47 | $467.74 |
6 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 $79.43 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $31.62 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $120.23 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $23.99 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.85 | $25.12 | $30.20 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $954.99 Median $1,202.26 Typical High $1,737.80 | Facility | 50 · Both sides | $954.99 | $1,202.26 | $1,737.80 |
Where Utah sits
The same service costs 3.2 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· 44th of 51
$251
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.