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 $109.65 Median $3,162.28 Typical High $4,570.88 | Facility | None | $109.65 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | None | $81.28 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $147.91 | Professional | None | $93.33 | $123.03 | $147.91 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $74.13 | Professional | None | $51.29 | $58.88 | $74.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $147.91 | Professional | None | $97.72 | $114.82 | $147.91 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $154.88 | Professional | None | $77.62 | $114.82 | $154.88 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $162.18 | Professional | None | $72.44 | $95.50 | $162.18 |
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 $40.74 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $40.74 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $83.18 Typical High $83.18 | Professional | 54 · Surgery only | $61.66 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $12.30 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $10.96 |
Where Utah sits
The same service costs 6.5 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· 42nd of 51
$110
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.