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 $144.54 Median $2,884.03 Typical High $4,786.30 | Facility | None | $144.54 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $288.40 | Professional | None | $138.04 | $251.19 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,023.29 | Facility | None | $954.99 | $1,000.00 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $446.68 | Professional | None | $154.88 | $263.03 | $446.68 |
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 $2,754.23 Median $3,548.13 Typical High $5,128.61 | Facility | None | $2,754.23 | $3,548.13 | $5,128.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $398.11 | Professional | None | $151.36 | $269.15 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $524.81 | Professional | None | $144.54 | $316.23 | $524.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $457.09 | Professional | None | $117.49 | $223.87 | $457.09 |
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 $72.44 Median $107.15 Typical High $141.25 | Professional | 52 · Reduced service | $72.44 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $56.23 | Professional | 53 · Discontinued | $28.84 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $107.15 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $21.38 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $28.18 |
Where Utah sits
The same service costs 3.9 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· 43rd 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.