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 $134.90 Median $2,951.21 Typical High $4,570.88 | Facility | None | $134.90 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $213.80 | Professional | None | $97.72 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $371.54 Typical High $380.19 | Facility | None | $354.81 | $371.54 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $229.09 | Professional | None | $104.71 | $154.88 | $229.09 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | None | $95.50 | $114.82 | $141.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,380.38 | $1,995.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $223.87 | Professional | None | $100.00 | $169.82 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $61.66 Median $173.78 Typical High $275.42 | Professional | None | $61.66 | $173.78 | $275.42 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,202.26 Typical High $2,818.38 | Facility | None | $251.19 | $1,202.26 | $2,818.38 |
United Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $234.42 | Professional | None | $79.43 | $131.83 | $234.42 |
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 $51.29 Median $67.61 Typical High $107.15 | Professional | 52 · Reduced service | $51.29 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $20.89 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $158.49 | Professional | 54 · Surgery only | $77.62 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.95 Typical High $32.36 | Professional | 55 · Aftercare only | $15.49 | $19.95 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $21.38 |
Where Utah sits
The same service costs 3.6 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· 48th of 51
$135
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.