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 $426.58 Median $2,884.03 Typical High $4,786.30 | Facility | None | $426.58 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $954.99 Typical High $1,995.26 | Professional | None | $309.03 | $954.99 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $1,318.26 Typical High $1,995.26 | Professional | None | $407.38 | $1,318.26 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $6,456.54 Typical High $9,332.54 | Facility | None | $5,248.07 | $6,456.54 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $776.25 Typical High $1,949.84 | Professional | None | $354.81 | $776.25 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $660.69 Typical High $3,981.07 | Professional | None | $288.40 | $660.69 | $3,981.07 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $363.08 Median $1,621.81 Typical High $2,691.53 | Professional | None | $363.08 | $1,621.81 | $2,691.53 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $8,128.31 Typical High $8,317.64 | Facility | None | $5,128.61 | $8,128.31 | $8,317.64 |
United Setting Professional Modifier None Typical Low $288.40 Median $1,202.26 Typical High $2,630.27 | Professional | None | $288.40 | $1,202.26 | $2,630.27 |
6 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 $213.80 Median $416.87 Typical High $1,000.00 | Professional | 52 · Reduced service | $213.80 | $416.87 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $169.82 Typical High $398.11 | Professional | 53 · Discontinued | $85.11 | $169.82 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $630.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $323.59 | $630.96 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $125.89 Typical High $295.12 | Professional | 55 · Aftercare only | $64.57 | $125.89 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $83.18 Typical High $199.53 | Professional | 56 · Pre-op care only | $42.66 | $83.18 | $199.53 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $9,772.37 Typical High $14,125.38 | Facility | 50 · Both sides | $7,762.47 | $9,772.37 | $14,125.38 |
Where Utah sits
The same service costs 5.1 times more in Wisconsin than in Maryland. 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· 38th of 51
$1,072
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.