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 $165.96 Median $3,162.28 Typical High $4,570.88 | Facility | None | $165.96 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
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 $147.91 Median $147.91 Typical High $288.40 | Professional | None | $147.91 | $147.91 | $288.40 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $138.04 | Professional | None | $97.72 | $112.20 | $138.04 |
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 $208.93 Median $234.42 Typical High $275.42 | Professional | None | $208.93 | $234.42 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $316.23 | Professional | None | $177.83 | $269.15 | $316.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $446.68 | Professional | None | $123.03 | $223.87 | $446.68 |
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 $117.49 Median $173.78 Typical High $346.74 | Professional | None | $117.49 | $173.78 | $346.74 |
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 $83.18 Median $83.18 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $125.89 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $21.88 |
Where Utah sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 51st of 51
$132
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.