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 $169.82 Median $3,162.28 Typical High $4,570.88 | Facility | None | $169.82 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $169.82 | Professional | None | $120.23 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,011.87 | $5,248.07 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $204.17 | Professional | None | $134.90 | $154.88 | $204.17 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $102.33 | Professional | None | $74.13 | $85.11 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $17,782.79 | Facility | None | $9,120.11 | $12,302.69 | $17,782.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $194.98 | Professional | None | $147.91 | $169.82 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $234.42 | Professional | None | $125.89 | $199.53 | $234.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $239.88 | Professional | None | $95.50 | $162.18 | $239.88 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $213.80 | Professional | None | $104.71 | $123.03 | $213.80 |
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 $58.88 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $58.88 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $23.99 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $125.89 Typical High $125.89 | Professional | 54 · Surgery only | $89.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.02 | $16.98 | $16.98 |
Where Utah sits
The same service costs 4.8 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
$97.72
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.