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 $549.54 Median $3,162.28 Typical High $8,511.38 | Facility | None | $549.54 | $3,162.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $1,445.44 Typical High $2,454.71 | Professional | None | $549.54 | $1,445.44 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,511.89 | $2,630.27 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,344.23 | Professional | None | $512.86 | $1,513.56 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,570.40 | Professional | None | $812.83 | $1,258.93 | $2,570.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $6,456.54 Typical High $9,332.54 | Facility | None | $5,248.07 | $6,456.54 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $446.68 Median $954.99 Typical High $3,162.28 | Professional | None | $446.68 | $954.99 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $263.03 Median $1,584.89 Typical High $5,754.40 | Professional | None | $263.03 | $1,584.89 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,258.93 Typical High $2,691.53 | Professional | None | $363.08 | $1,258.93 | $2,691.53 |
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 $269.15 Median $501.19 Typical High $1,230.27 | Professional | 52 · Reduced service | $269.15 | $501.19 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $204.17 Typical High $489.78 | Professional | 53 · Discontinued | $109.65 | $204.17 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $758.58 Typical High $1,862.09 | Professional | 54 · Surgery only | $407.38 | $758.58 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $151.36 Typical High $371.54 | Professional | 55 · Aftercare only | $81.28 | $151.36 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $102.33 Typical High $245.47 | Professional | 56 · Pre-op care only | $54.95 | $102.33 | $245.47 |
Where Utah sits
The same service costs 5.1 times more in Alaska 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· 10th of 51
$1,995
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.