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 $575.44 Median $4,570.88 Typical High $8,912.51 | Facility | None | $575.44 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | None | $478.63 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $6,025.60 Typical High $6,165.95 | Facility | None | $5,888.44 | $6,025.60 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $891.25 | Professional | None | $562.34 | $645.65 | $891.25 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $467.74 | Professional | None | $338.84 | $389.05 | $467.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,848.93 Median $21,379.62 Typical High $27,542.29 | Facility | None | $15,848.93 | $21,379.62 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $851.14 | Professional | None | $588.84 | $691.83 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $346.74 Median $676.08 Typical High $977.24 | Professional | None | $346.74 | $676.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,000.00 | Professional | None | $436.52 | $537.03 | $1,000.00 |
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 $257.04 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $57.54 |
Where Utah sits
The same service costs 3.9 times more in Alaska 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· 50th of 51
$525
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.