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 $125.89 Median $2,884.03 Typical High $4,786.30 | Facility | None | $125.89 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $194.98 | Professional | None | $95.50 | $144.54 | $194.98 |
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 $117.49 Median $169.82 Typical High $251.19 | Professional | None | $117.49 | $169.82 | $251.19 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $173.78 | Professional | None | $120.23 | $141.25 | $173.78 |
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 $112.20 Median $194.98 Typical High $257.04 | Professional | None | $112.20 | $194.98 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Select Health Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $338.84 | Professional | None | $95.50 | $154.88 | $338.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $338.84 | Professional | None | $100.00 | $213.80 | $338.84 |
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 $91.20 Median $141.25 Typical High $239.88 | Professional | None | $91.20 | $141.25 | $239.88 |
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 $63.10 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $18.62 |
Where Utah sits
The same service costs 3.6 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· 43rd of 51
$148
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.