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 $79.43 Median $2,951.21 Typical High $4,570.88 | Facility | None | $79.43 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $109.65 | Professional | None | $63.10 | $79.43 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $57.54 Typical High $58.88 | Facility | None | $54.95 | $57.54 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $114.82 | Professional | None | $72.44 | $89.13 | $114.82 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | None | $48.98 | $56.23 | $69.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,466.84 | Facility | None | $2,454.71 | $3,019.95 | $4,466.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $112.20 | Professional | None | $75.86 | $93.33 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $134.90 | Professional | None | $63.10 | $95.50 | $134.90 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $151.36 | Professional | None | $47.86 | $95.50 | $151.36 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $125.89 | Professional | None | $56.23 | $77.62 | $125.89 |
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 $36.31 Median $39.81 Typical High $54.95 | Professional | 52 · Reduced service | $36.31 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.85 Typical High $21.88 | Professional | 53 · Discontinued | $14.45 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $58.88 Typical High $83.18 | Professional | 54 · Surgery only | $53.70 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $16.60 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.94 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.24 | $7.94 | $10.96 |
Where Utah sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 46th of 51
$69.18
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.