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 $69.18 Median $2,951.21 Typical High $4,570.88 | Facility | None | $69.18 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $112.20 Typical High $162.18 | Professional | None | $51.29 | $112.20 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $144.54 | Facility | None | $134.90 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $186.21 | Professional | None | $63.10 | $128.82 | $186.21 |
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 $1,445.44 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,445.44 | $1,862.09 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $190.55 | Professional | None | $60.26 | $117.49 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $263.03 | Professional | None | $51.29 | $85.11 | $263.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $251.19 | Professional | None | $54.95 | $131.83 | $251.19 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $181.97 | Professional | None | $46.77 | $100.00 | $181.97 |
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 $33.11 Median $58.88 Typical High $74.13 | Professional | 52 · Reduced service | $33.11 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.99 Typical High $29.51 | Professional | 53 · Discontinued | $13.18 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $50.12 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $10.00 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.75 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.61 | $11.75 | $14.79 |
Where Utah sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 14th of 51
$132
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.