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 $74.13 Median $2,951.21 Typical High $4,570.88 | Facility | None | $74.13 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $257.04 Typical High $489.78 | Professional | None | $51.29 | $257.04 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $269.15 Typical High $436.52 | Professional | None | $66.07 | $269.15 | $436.52 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | None | $162.18 | $194.98 | $239.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $269.15 Typical High $407.38 | Professional | None | $58.88 | $269.15 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $47.86 Median $112.20 Typical High $870.96 | Professional | None | $47.86 | $112.20 | $870.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $54.95 Median $323.59 Typical High $588.84 | Professional | None | $54.95 | $323.59 | $588.84 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $5,128.61 | Facility | None | $1,698.24 | $4,466.84 | $5,128.61 |
United Setting Professional Modifier None Typical Low $46.77 Median $251.19 Typical High $549.54 | Professional | None | $46.77 | $251.19 | $549.54 |
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 $37.15 Median $72.44 Typical High $245.47 | Professional | 52 · Reduced service | $37.15 | $72.44 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $28.84 Typical High $97.72 | Professional | 53 · Discontinued | $14.79 | $28.84 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $109.65 Typical High $371.54 | Professional | 54 · Surgery only | $54.95 | $109.65 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $21.88 Typical High $74.13 | Professional | 55 · Aftercare only | $10.96 | $21.88 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $14.45 Typical High $48.98 | Professional | 56 · Pre-op care only | $7.41 | $14.45 | $48.98 |
Where Utah sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 40th of 51
$204
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.