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 $380.19 Median $2,884.03 Typical High $4,786.30 | Facility | None | $380.19 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,023.29 Typical High $1,737.80 | Professional | None | $251.19 | $1,023.29 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $1,318.26 Typical High $1,862.09 | Professional | None | $338.84 | $1,318.26 | $1,862.09 |
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 Professional Modifier None Typical Low $288.40 Median $1,318.26 Typical High $1,995.26 | Professional | None | $288.40 | $1,318.26 | $1,995.26 |
Select Health Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $549.54 Typical High $5,754.40 | Professional | None | $239.88 | $549.54 | $5,754.40 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $302.00 Median $1,584.89 Typical High $2,570.40 | Professional | None | $302.00 | $1,584.89 | $2,570.40 |
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 $239.88 Median $1,096.48 Typical High $2,511.89 | Professional | None | $239.88 | $1,096.48 | $2,511.89 |
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 $190.55 Median $354.81 Typical High $870.96 | Professional | 52 · Reduced service | $190.55 | $354.81 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $141.25 Typical High $346.74 | Professional | 53 · Discontinued | $75.86 | $141.25 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $537.03 Typical High $1,318.26 | Professional | 54 · Surgery only | $288.40 | $537.03 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $107.15 Typical High $263.03 | Professional | 55 · Aftercare only | $57.54 | $107.15 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $70.79 Typical High $173.78 | Professional | 56 · Pre-op care only | $38.02 | $70.79 | $173.78 |
Where Utah sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 25th of 51
$1,047
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.