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 $323.59 Median $3,162.28 Typical High $6,025.60 | Facility | None | $323.59 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | None | $251.19 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $398.11 | Professional | None | $281.84 | $309.03 | $398.11 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $199.53 | Professional | None | $147.91 | $165.96 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $398.11 | Professional | None | $302.00 | $338.84 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $467.74 | Professional | None | $257.04 | $398.11 | $467.74 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $794.33 | Professional | None | $199.53 | $331.13 | $794.33 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $446.68 | Professional | None | $218.78 | $251.19 | $446.68 |
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 $125.89 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $32.36 | $32.36 |
Where Utah sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 51st of 51
$195
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.