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 $91.20 Median $2,951.21 Typical High $4,570.88 | Facility | None | $91.20 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $134.90 | Professional | None | $67.61 | $91.20 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $56.23 Typical High $57.54 | Facility | None | $53.70 | $56.23 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $147.91 | Professional | None | $83.18 | $107.15 | $147.91 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | None | $48.98 | $56.23 | $69.18 |
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 $79.43 Median $112.20 Typical High $141.25 | Professional | None | $79.43 | $112.20 | $141.25 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $162.18 | Professional | None | $61.66 | $102.33 | $162.18 |
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 $64.57 Median $87.10 Typical High $151.36 | Professional | None | $64.57 | $87.10 | $151.36 |
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 $40.74 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $18.20 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $67.61 Typical High $89.13 | Professional | 54 · Surgery only | $60.26 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $12.02 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.13 | $9.12 | $12.02 |
Where Utah sits
The same service costs 3.5 times more in Wisconsin 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· 46th of 51
$87.10
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.