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 $537.03 Median $2,884.03 Typical High $4,786.30 | Facility | None | $537.03 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,513.56 Typical High $3,162.28 | Professional | None | $407.38 | $1,513.56 | $3,162.28 |
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 $501.19 Median $1,778.28 Typical High $2,818.38 | Professional | None | $501.19 | $1,778.28 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $2,290.87 Typical High $3,162.28 | Professional | None | $229.09 | $2,290.87 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,370.32 Median $7,079.46 Typical High $10,232.93 | Facility | None | $5,370.32 | $7,079.46 | $10,232.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $2,951.21 | Professional | None | $478.63 | $831.76 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Select Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $575.44 Median $2,511.89 Typical High $6,606.93 | Professional | None | $575.44 | $2,511.89 | $6,606.93 |
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 $371.54 Median $1,479.11 Typical High $3,235.94 | Professional | None | $371.54 | $1,479.11 | $3,235.94 |
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 $245.47 Median $426.58 Typical High $1,230.27 | Professional | 52 · Reduced service | $245.47 | $426.58 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $169.82 Typical High $489.78 | Professional | 53 · Discontinued | $97.72 | $169.82 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $645.65 Typical High $1,819.70 | Professional | 54 · Surgery only | $371.54 | $645.65 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $128.82 Typical High $363.08 | Professional | 55 · Aftercare only | $74.13 | $128.82 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $85.11 Typical High $245.47 | Professional | 56 · Pre-op care only | $48.98 | $85.11 | $245.47 |
Where Utah sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 8th of 51
$2,239
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.