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 $380.19 Median $4,570.88 Typical High $8,912.51 | Facility | None | $380.19 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | None | $269.15 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,949.84 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $489.78 | Professional | None | $302.00 | $363.08 | $489.78 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | None | $169.82 | $194.98 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,623.41 Median $7,079.46 Typical High $10,232.93 | Facility | None | $5,623.41 | $7,079.46 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $512.86 | Professional | None | $323.59 | $389.05 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $398.11 Typical High $489.78 | Professional | None | $186.21 | $398.11 | $489.78 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $549.54 | Professional | None | $239.88 | $316.23 | $549.54 |
3 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 54 · Surgery only Typical Low $204.17 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $204.17 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.92 | $38.02 | $38.02 |
Where Utah sits
The same service costs 7.2 times more in Oklahoma than in New York. 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· 50th of 51
$275
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.