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 $38.90 Median $2,951.21 Typical High $4,570.88 | Facility | None | $38.90 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $53.70 Typical High $100.00 | Professional | None | $28.18 | $53.70 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $51.29 Typical High $77.62 | Professional | None | $36.31 | $51.29 | $77.62 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $35.48 | Professional | None | $23.44 | $29.51 | $35.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $389.05 | Facility | None | $204.17 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $72.44 | Professional | None | $31.62 | $54.95 | $72.44 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Select Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $120.23 | Professional | None | $33.88 | $60.26 | $120.23 |
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 $26.30 Median $44.67 Typical High $81.28 | Professional | None | $26.30 | $44.67 | $81.28 |
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 $16.22 Median $20.42 Typical High $40.74 | Professional | 52 · Reduced service | $16.22 | $20.42 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.32 Typical High $16.22 | Professional | 53 · Discontinued | $6.46 | $8.32 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $30.90 Typical High $60.26 | Professional | 54 · Surgery only | $23.99 | $30.90 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.17 Typical High $12.02 | Professional | 55 · Aftercare only | $4.79 | $6.17 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.07 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.24 | $4.07 | $8.13 |
Where Utah sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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· 51st of 51
$38.90
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.