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 $134.90 Median $2,951.21 Typical High $4,570.88 | Facility | None | $134.90 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $269.15 | Professional | None | $134.90 | $208.93 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $1,737.80 | Facility | None | $1,621.81 | $1,698.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $302.00 | Professional | None | $123.03 | $223.87 | $302.00 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | None | $165.96 | $199.53 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,466.84 Median $5,623.41 Typical High $8,128.31 | Facility | None | $4,466.84 | $5,623.41 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $309.03 | Professional | None | $125.89 | $223.87 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $426.58 | Professional | None | $107.15 | $181.97 | $426.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $117.49 Median $257.04 Typical High $457.09 | Professional | None | $117.49 | $257.04 | $457.09 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $309.03 | Professional | None | $95.50 | $169.82 | $309.03 |
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 $67.61 Median $100.00 Typical High $134.90 | Professional | 52 · Reduced service | $67.61 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $39.81 Typical High $53.70 | Professional | 53 · Discontinued | $26.92 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $100.00 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $20.42 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.49 | $19.95 | $26.92 |
Where Utah sits
The same service costs 4.0 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· 25th of 51
$200
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.