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 $109.65 Median $2,951.21 Typical High $4,570.88 | Facility | None | $109.65 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $186.21 Typical High $239.88 | Professional | None | $91.20 | $186.21 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $173.78 | Facility | None | $162.18 | $169.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $275.42 | Professional | None | $107.15 | $218.78 | $275.42 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $173.78 | Professional | None | $120.23 | $141.25 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,818.38 | Facility | None | $1,479.11 | $1,949.84 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $281.84 | Professional | None | $102.33 | $186.21 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $436.52 | Professional | None | $87.10 | $162.18 | $436.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $102.33 Median $234.42 Typical High $389.05 | Professional | None | $102.33 | $234.42 | $389.05 |
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 $81.28 Median $165.96 Typical High $281.84 | Professional | None | $81.28 | $165.96 | $281.84 |
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 $54.95 Median $91.20 Typical High $120.23 | Professional | 52 · Reduced service | $54.95 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $37.15 Typical High $47.86 | Professional | 53 · Discontinued | $21.88 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $83.18 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $16.60 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.62 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.96 | $18.62 | $23.99 |
Where Utah sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 44th of 51
$148
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.