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 $1,479.11 Typical High $2,398.83 | Professional | None | $346.74 | $1,479.11 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $2,187.76 Typical High $3,019.95 | Professional | None | $478.63 | $2,187.76 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,905.46 | $2,344.23 |
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 $3,090.30 | Professional | None | $457.09 | $1,023.29 | $3,090.30 |
Select Health Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $831.76 Typical High $4,897.79 | Professional | None | $380.19 | $831.76 | $4,897.79 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $467.74 Median $2,818.38 Typical High $4,897.79 | Professional | None | $467.74 | $2,818.38 | $4,897.79 |
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 $3,981.07 | Professional | None | $354.81 | $1,698.24 | $3,981.07 |
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 $1,202.26 | Professional | 52 · Reduced service | $251.19 | $524.81 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $208.93 Typical High $478.63 | Professional | 53 · Discontinued | $100.00 | $208.93 | $478.63 |
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 $363.08 | Professional | 55 · Aftercare only | $75.86 | $158.49 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $104.71 Typical High $239.88 | Professional | 56 · Pre-op care only | $50.12 | $104.71 | $239.88 |
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 6.2 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· 19th of 51
$1,905
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.