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 $95.50 Median $2,951.21 Typical High $4,570.88 | Facility | None | $95.50 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $154.88 | Professional | None | $66.07 | $107.15 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $81.28 Typical High $83.18 | Facility | None | $77.62 | $81.28 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $162.18 | Professional | None | $70.79 | $109.65 | $162.18 |
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 $66.07 Median $120.23 Typical High $162.18 | Professional | None | $66.07 | $120.23 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $218.78 | Professional | None | $67.61 | $125.89 | $218.78 |
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 $52.48 Median $93.33 Typical High $169.82 | Professional | None | $52.48 | $93.33 | $169.82 |
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 $37.15 Median $47.86 Typical High $75.86 | Professional | 52 · Reduced service | $37.15 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.05 Typical High $30.90 | Professional | 53 · Discontinued | $14.79 | $19.05 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $70.79 Typical High $114.82 | Professional | 54 · Surgery only | $54.95 | $70.79 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.13 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $14.13 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $15.49 |
Where Utah sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 47th of 51
$95.50
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.