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 $114.82 Median $2,951.21 Typical High $4,570.88 | Facility | None | $114.82 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $186.21 Typical High $309.03 | Professional | None | $77.62 | $186.21 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $281.84 | Professional | None | $102.33 | $190.55 | $281.84 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | None | $95.50 | $114.82 | $138.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $251.19 | Professional | None | $87.10 | $194.98 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $131.83 | Professional | None | $74.13 | $125.89 | $131.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $91.20 Median $218.78 Typical High $363.08 | Professional | None | $91.20 | $218.78 | $363.08 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $5,128.61 | Facility | None | $1,698.24 | $4,466.84 | $5,128.61 |
United Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $371.54 | Professional | None | $74.13 | $173.78 | $371.54 |
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 $57.54 Median $97.72 Typical High $154.88 | Professional | 52 · Reduced service | $57.54 | $97.72 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.90 Typical High $61.66 | Professional | 53 · Discontinued | $22.91 | $38.90 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $144.54 Typical High $234.42 | Professional | 54 · Surgery only | $87.10 | $144.54 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.84 Typical High $46.77 | Professional | 55 · Aftercare only | $17.38 | $28.84 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.50 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.48 | $19.50 | $30.90 |
Where Utah sits
The same service costs 2.7 times more in Wisconsin 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
$117
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.