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 $138.04 Median $2,951.21 Typical High $4,570.88 | Facility | None | $138.04 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $416.87 Typical High $588.84 | Professional | None | $97.72 | $416.87 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $426.58 | Facility | None | $389.05 | $416.87 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $407.38 Typical High $660.69 | Professional | None | $123.03 | $407.38 | $660.69 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $407.38 Typical High $891.25 | Professional | None | $190.55 | $407.38 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,862.09 | Facility | None | $977.24 | $1,288.25 | $1,862.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $223.87 Typical High $741.31 | Professional | None | $107.15 | $223.87 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $117.49 Median $549.54 Typical High $1,513.56 | Professional | None | $117.49 | $549.54 | $1,513.56 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $11,481.54 | Facility | None | $251.19 | $1,202.26 | $11,481.54 |
United Setting Professional Modifier None Typical Low $91.20 Median $363.08 Typical High $776.25 | Professional | None | $91.20 | $363.08 | $776.25 |
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 $69.18 Median $125.89 Typical High $295.12 | Professional | 52 · Reduced service | $69.18 | $125.89 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $50.12 Typical High $120.23 | Professional | 53 · Discontinued | $28.18 | $50.12 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $186.21 Typical High $446.68 | Professional | 54 · Surgery only | $104.71 | $186.21 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $37.15 Typical High $89.13 | Professional | 55 · Aftercare only | $20.89 | $37.15 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $13.80 | $25.12 | $58.88 |
Where Utah sits
The same service costs 7.8 times more in Oklahoma than in Nebraska. 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· 11th of 51
$525
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.