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 $63.10 Median $2,951.21 Typical High $4,570.88 | Facility | None | $63.10 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $89.13 Typical High $169.82 | Professional | None | $43.65 | $89.13 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $67.61 | Facility | None | $64.57 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $128.82 | Professional | None | $43.65 | $85.11 | $128.82 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $724.44 | Facility | None | $398.11 | $501.19 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $37.15 Median $95.50 Typical High $123.03 | Professional | None | $37.15 | $95.50 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $38.90 Median $97.72 Typical High $151.36 | Professional | None | $38.90 | $97.72 | $151.36 |
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 $31.62 Median $70.79 Typical High $134.90 | Professional | None | $31.62 | $70.79 | $134.90 |
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 $23.44 Median $34.67 Typical High $58.88 | Professional | 52 · Reduced service | $23.44 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.80 Typical High $23.44 | Professional | 53 · Discontinued | $9.33 | $13.80 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $51.29 Typical High $89.13 | Professional | 54 · Surgery only | $35.48 | $51.29 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.47 Typical High $17.78 | Professional | 55 · Aftercare only | $7.08 | $10.47 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.92 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.68 | $6.92 | $11.75 |
Where Utah sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 19th of 51
$89.13
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.