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 $51.29 Median $2,951.21 Typical High $4,570.88 | Facility | None | $51.29 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $151.36 | Professional | None | $41.69 | $83.18 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $93.33 Typical High $165.96 | Professional | None | $46.77 | $93.33 | $165.96 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | None | $95.50 | $114.82 | $138.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $389.05 | Facility | None | $204.17 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $95.50 Typical High $169.82 | Professional | None | $52.48 | $95.50 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $223.87 | Professional | None | $43.65 | $74.13 | $223.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $51.29 Median $123.03 Typical High $218.78 | Professional | None | $51.29 | $123.03 | $218.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $38.90 Median $75.86 Typical High $154.88 | Professional | None | $38.90 | $75.86 | $154.88 |
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 $25.70 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $25.70 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $20.42 Typical High $23.44 | Professional | 53 · Discontinued | $10.23 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $75.86 Typical High $89.13 | Professional | 54 · Surgery only | $38.90 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $7.76 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $10.23 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.13 | $10.23 | $11.75 |
Where Utah sits
The same service costs 3.4 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· 16th of 51
$107
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.