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 $114.82 Median $2,951.21 Typical High $4,570.88 | Facility | None | $114.82 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $251.19 | Professional | None | $109.65 | $190.55 | $251.19 |
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 $104.71 Median $213.80 Typical High $295.12 | Professional | None | $104.71 | $213.80 | $295.12 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $208.93 | Professional | None | $141.25 | $169.82 | $208.93 |
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 $107.15 Median $213.80 Typical High $295.12 | Professional | None | $107.15 | $213.80 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $407.38 | Professional | None | $91.20 | $154.88 | $407.38 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $104.71 Median $245.47 Typical High $416.87 | Professional | None | $104.71 | $245.47 | $416.87 |
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 $83.18 Median $154.88 Typical High $295.12 | Professional | None | $83.18 | $154.88 | $295.12 |
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 $57.54 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $22.91 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $16.98 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.48 | $19.05 | $25.12 |
Where Utah sits
The same service costs 4.5 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· 35th of 51
$170
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.