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 $83.18 Median $3,162.28 Typical High $4,570.88 | Facility | None | $83.18 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $83.18 Typical High $83.18 | Professional | None | $56.23 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $295.12 Typical High $302.00 | Facility | None | $275.42 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $87.10 | Professional | None | $56.23 | $72.44 | $87.10 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $34.67 | Professional | None | $25.12 | $28.84 | $34.67 |
Regence BlueShield Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,318.26 | Facility | None | $724.44 | $891.25 | $1,318.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $79.43 | Professional | None | $60.26 | $69.18 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $91.20 | Professional | None | $52.48 | $79.43 | $91.20 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $41.69 Median $69.18 Typical High $144.54 | Professional | None | $41.69 | $69.18 | $144.54 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $97.72 | Professional | None | $46.77 | $54.95 | $97.72 |
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 $28.18 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $28.18 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $63.10 Typical High $63.10 | Professional | 54 · Surgery only | $42.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $8.51 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.62 | $8.32 | $8.32 |
Where Utah sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 35th of 51
$60.26
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.