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 $141.25 Median $3,162.28 Typical High $6,025.60 | Facility | None | $141.25 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | None | $112.20 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $173.78 | Professional | None | $123.03 | $138.04 | $173.78 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $69.18 | Professional | None | $51.29 | $57.54 | $69.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | None | $131.83 | $147.91 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $199.53 | Professional | None | $112.20 | $169.82 | $199.53 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $208.93 | Professional | None | $97.72 | $144.54 | $208.93 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $199.53 | Professional | None | $95.50 | $109.65 | $199.53 |
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 $54.95 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $22.39 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $83.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $14.13 |
Where Utah sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 28th of 51
$132
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.