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 $575.44 Median $3,090.30 Typical High $4,786.30 | Facility | None | $575.44 | $3,090.30 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,737.80 Typical High $3,090.30 | Professional | None | $398.11 | $1,737.80 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $2,137.96 Typical High $3,090.30 | Professional | None | $537.03 | $2,137.96 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,621.81 | $1,995.26 |
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 $436.52 Median $1,096.48 Typical High $2,884.03 | Professional | None | $436.52 | $1,096.48 | $2,884.03 |
Select Health Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $3,890.45 | Professional | None | $354.81 | $812.83 | $3,890.45 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $478.63 Median $2,754.23 Typical High $4,570.88 | Professional | None | $478.63 | $2,754.23 | $4,570.88 |
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 $371.54 Median $1,949.84 Typical High $4,168.69 | Professional | None | $371.54 | $1,949.84 | $4,168.69 |
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 $288.40 Median $537.03 Typical High $1,548.82 | Professional | 52 · Reduced service | $288.40 | $537.03 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $218.78 Typical High $616.60 | Professional | 53 · Discontinued | $114.82 | $218.78 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $812.83 Typical High $2,290.87 | Professional | 54 · Surgery only | $426.58 | $812.83 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $162.18 Typical High $457.09 | Professional | 55 · Aftercare only | $87.10 | $162.18 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $109.65 Typical High $309.03 | Professional | 56 · Pre-op care only | $57.54 | $109.65 | $309.03 |
Where Utah sits
The same service costs 6.9 times more in Wisconsin 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· 36th of 51
$1,660
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.