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 $107.15 Median $2,951.21 Typical High $4,570.88 | Facility | None | $107.15 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $234.42 | Professional | None | $102.33 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $602.56 Typical High $616.60 | Facility | None | $575.44 | $602.56 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $309.03 | Professional | None | $100.00 | $190.55 | $309.03 |
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 $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 $100.00 Median $229.09 Typical High $323.59 | Professional | None | $100.00 | $229.09 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $416.87 | Professional | None | $85.11 | $138.04 | $416.87 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $269.15 Typical High $467.74 | Professional | None | $100.00 | $269.15 | $467.74 |
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 $79.43 Median $158.49 Typical High $295.12 | Professional | None | $79.43 | $158.49 | $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 $53.70 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $53.70 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $21.38 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $16.22 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.72 | $19.95 | $22.91 |
Where Utah sits
The same service costs 4.1 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· 27th of 51
$191
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.