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 $234.42 Median $2,884.03 Typical High $4,786.30 | Facility | None | $234.42 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $549.54 | Professional | None | $208.93 | $371.54 | $549.54 |
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 $218.78 Median $407.38 Typical High $588.84 | Professional | None | $218.78 | $407.38 | $588.84 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $389.05 | Professional | None | $263.03 | $309.03 | $389.05 |
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 $204.17 Median $380.19 Typical High $602.56 | Professional | None | $204.17 | $380.19 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $128.82 Median $467.74 Typical High $707.95 | Professional | None | $128.82 | $467.74 | $707.95 |
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 $162.18 Median $346.74 Typical High $707.95 | Professional | None | $162.18 | $346.74 | $707.95 |
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 $104.71 Median $173.78 Typical High $275.42 | Professional | 52 · Reduced service | $104.71 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $69.18 Typical High $109.65 | Professional | 53 · Discontinued | $41.69 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $263.03 Typical High $407.38 | Professional | 54 · Surgery only | $158.49 | $263.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $52.48 Typical High $81.28 | Professional | 55 · Aftercare only | $31.62 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $34.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $20.89 | $34.67 | $54.95 |
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· 46th of 51
$355
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.