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 $53.70 Median $2,951.21 Typical High $4,570.88 | Facility | None | $53.70 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $114.82 Typical High $199.53 | Professional | None | $37.15 | $114.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $173.78 Typical High $257.04 | Professional | None | $52.48 | $173.78 | $257.04 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $173.78 | Professional | None | $117.49 | $138.04 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $100.00 Typical High $275.42 | Professional | None | $45.71 | $100.00 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Select Health Setting Professional Modifier None Typical Low $37.15 Median $69.18 Typical High $331.13 | Professional | None | $37.15 | $69.18 | $331.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $37.15 Median $213.80 Typical High $354.81 | Professional | None | $37.15 | $213.80 | $354.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $5,128.61 | Facility | None | $1,698.24 | $4,466.84 | $5,128.61 |
United Setting Professional Modifier None Typical Low $38.90 Median $138.04 Typical High $346.74 | Professional | None | $38.90 | $138.04 | $346.74 |
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 $26.92 Median $56.23 Typical High $100.00 | Professional | 52 · Reduced service | $26.92 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $22.39 Typical High $39.81 | Professional | 53 · Discontinued | $10.72 | $22.39 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $83.18 Typical High $147.91 | Professional | 54 · Surgery only | $39.81 | $83.18 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $16.60 Typical High $29.51 | Professional | 55 · Aftercare only | $7.94 | $16.60 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $11.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.37 | $11.22 | $19.95 |
Where Utah sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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
$141
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.