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 $114.82 Median $2,951.21 Typical High $4,570.88 | Facility | None | $114.82 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $158.49 | Professional | None | $54.95 | $114.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $147.91 | Professional | None | $69.18 | $109.65 | $147.91 |
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 $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 $54.95 Median $112.20 Typical High $131.83 | Professional | None | $54.95 | $112.20 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Select Health Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $162.18 | Professional | None | $46.77 | $72.44 | $162.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $162.18 | Professional | None | $52.48 | $97.72 | $162.18 |
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 $43.65 Median $83.18 Typical High $147.91 | Professional | None | $43.65 | $83.18 | $147.91 |
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 $27.54 Median $57.54 Typical High $79.43 | Professional | 52 · Reduced service | $27.54 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $10.96 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $87.10 Typical High $117.49 | Professional | 54 · Surgery only | $41.69 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $17.38 Typical High $23.44 | Professional | 55 · Aftercare only | $8.32 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $11.48 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.50 | $11.48 | $15.85 |
Where Utah sits
The same service costs 2.5 times more in North Carolina than in Florida. 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
$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.