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 $190.55 Median $4,570.88 Typical High $8,912.51 | Facility | None | $190.55 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $257.04 | Professional | None | $177.83 | $190.55 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $2,884.03 | Facility | None | $2,691.53 | $2,818.38 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $389.05 | Professional | None | $218.78 | $257.04 | $389.05 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $138.04 | Professional | None | $97.72 | $114.82 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $9,549.93 Typical High $14,125.38 | Facility | None | $7,413.10 | $9,549.93 | $14,125.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $338.84 | Professional | None | $234.42 | $275.42 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $416.87 | Professional | None | $138.04 | $269.15 | $416.87 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,698.24 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $398.11 | Professional | None | $177.83 | $218.78 | $398.11 |
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 $89.13 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $89.13 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $36.31 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $147.91 | Professional | 54 · Surgery only | $134.90 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $19.50 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $19.50 |
Where Utah sits
The same service costs 10.2 times more in Oklahoma 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· 50th of 51
$191
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.