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 $275.42 Median $4,570.88 Typical High $8,912.51 | Facility | None | $275.42 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | None | $213.80 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $4,168.69 Typical High $4,168.69 | Facility | None | $3,981.07 | $4,168.69 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $371.54 | Professional | None | $234.42 | $331.13 | $371.54 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $169.82 | Professional | None | $123.03 | $141.25 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,715.19 Median $14,125.38 Typical High $20,892.96 | Facility | None | $10,715.19 | $14,125.38 | $20,892.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $354.81 | Professional | None | $245.47 | $288.40 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $380.19 | Professional | None | $181.97 | $275.42 | $380.19 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $426.58 | Professional | None | $186.21 | $245.47 | $426.58 |
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 $107.15 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $107.15 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $42.66 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $27.54 |
Where Utah sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 49th of 51
$229
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.