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 $245.47 Median $2,951.21 Typical High $4,570.88 | Facility | None | $245.47 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $758.58 | Professional | None | $245.47 | $457.09 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $562.34 Typical High $812.83 | Professional | None | $218.78 | $562.34 | $812.83 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $549.54 | Professional | None | $380.19 | $446.68 | $549.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $870.96 | Professional | None | $186.21 | $416.87 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $1,513.56 | Professional | None | $154.88 | $354.81 | $1,513.56 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $147.91 Median $676.08 Typical High $1,096.48 | Professional | None | $147.91 | $676.08 | $1,096.48 |
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 $154.88 Median $446.68 Typical High $1,071.52 | Professional | None | $154.88 | $446.68 | $1,071.52 |
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 $123.03 Median $229.09 Typical High $380.19 | Professional | 52 · Reduced service | $123.03 | $229.09 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $91.20 Typical High $151.36 | Professional | 53 · Discontinued | $48.98 | $91.20 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $338.84 Typical High $575.44 | Professional | 54 · Surgery only | $186.21 | $338.84 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $67.61 Typical High $114.82 | Professional | 55 · Aftercare only | $37.15 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $45.71 Typical High $75.86 | Professional | 56 · Pre-op care only | $24.55 | $45.71 | $75.86 |
Where Utah sits
The same service costs 3.5 times more in Wisconsin 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· 39th of 51
$447
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.