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 $501.19 Median $3,162.28 Typical High $8,511.38 | Facility | None | $501.19 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,513.56 Typical High $2,344.23 | Professional | None | $346.74 | $1,513.56 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $2,137.96 Typical High $3,090.30 | Professional | None | $478.63 | $2,137.96 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,995.26 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,709.64 Median $11,220.18 Typical High $16,218.10 | Facility | None | $8,709.64 | $11,220.18 | $16,218.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $1,023.29 Typical High $3,235.94 | Professional | None | $457.09 | $1,023.29 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $870.96 Typical High $4,786.30 | Professional | None | $380.19 | $870.96 | $4,786.30 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $2,884.03 Typical High $5,011.87 | Professional | None | $478.63 | $2,884.03 | $5,011.87 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $15,135.61 Typical High $15,848.93 | Facility | None | $5,128.61 | $15,135.61 | $15,848.93 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,698.24 Typical High $4,168.69 | Professional | None | $354.81 | $1,698.24 | $4,168.69 |
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 $251.19 Median $524.81 Typical High $1,174.90 | Professional | 52 · Reduced service | $251.19 | $524.81 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $213.80 Typical High $467.74 | Professional | 53 · Discontinued | $100.00 | $213.80 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $794.33 Typical High $1,778.28 | Professional | 54 · Surgery only | $380.19 | $794.33 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $158.49 Typical High $354.81 | Professional | 55 · Aftercare only | $75.86 | $158.49 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $107.15 Typical High $234.42 | Professional | 56 · Pre-op care only | $50.12 | $107.15 | $234.42 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,882.50 Median $16,595.87 Typical High $23,988.33 | Facility | 50 · Both sides | $12,882.50 | $16,595.87 | $23,988.33 |
Where Utah sits
The same service costs 6.3 times more in Washington 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· 17th of 51
$1,995
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.