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 $40.74 Median $2,951.21 Typical High $4,570.88 | Facility | None | $40.74 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $91.20 Typical High $134.90 | Professional | None | $29.51 | $91.20 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $107.15 | Facility | None | $102.33 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $114.82 Typical High $165.96 | Professional | None | $39.81 | $114.82 | $165.96 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | None | $70.79 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,513.56 | Facility | None | $831.76 | $1,071.52 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $158.49 | Professional | None | $38.02 | $74.13 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $37.15 Median $123.03 Typical High $199.53 | Professional | None | $37.15 | $123.03 | $199.53 |
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 $30.20 Median $83.18 Typical High $173.78 | Professional | None | $30.20 | $83.18 | $173.78 |
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 $19.95 Median $40.74 Typical High $67.61 | Professional | 52 · Reduced service | $19.95 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.22 Typical High $26.92 | Professional | 53 · Discontinued | $8.13 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $61.66 Typical High $102.33 | Professional | 54 · Surgery only | $30.20 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.30 Typical High $20.42 | Professional | 55 · Aftercare only | $6.03 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.13 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.07 | $8.13 | $13.49 |
Where Utah sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 40th of 51
$93.33
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.