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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | None | $46.77 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $87.10 | Professional | None | $56.23 | $69.18 | $87.10 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $39.81 | Professional | None | $25.12 | $28.84 | $39.81 |
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 $58.88 Median $69.18 Typical High $81.28 | Professional | None | $58.88 | $69.18 | $81.28 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $32.36 Median $69.18 Typical High $102.33 | Professional | None | $32.36 | $69.18 | $102.33 |
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 $43.65 Median $57.54 Typical High $100.00 | Professional | None | $43.65 | $57.54 | $100.00 |
4 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 $23.44 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $23.44 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $9.33 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.08 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.68 | $5.13 | $5.13 |
Where Utah sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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· 38th of 51
$61.66
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.