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 $100.00 Median $3,162.28 Typical High $4,570.88 | Facility | None | $100.00 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | None | $77.62 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,479.11 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $154.88 | Professional | None | $87.10 | $100.00 | $154.88 |
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 $4,365.16 Median $5,888.44 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,888.44 | $8,511.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $123.03 | Professional | None | $93.33 | $109.65 | $123.03 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $51.29 Median $109.65 Typical High $134.90 | Professional | None | $51.29 | $109.65 | $134.90 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $154.88 | Professional | None | $69.18 | $87.10 | $154.88 |
6 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 $38.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 54 · Surgery only | $57.54 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.76 | $10.00 | $10.00 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,606.93 Median $8,912.51 Typical High $12,882.50 | Facility | 50 · Both sides | $6,606.93 | $8,912.51 | $12,882.50 |
Where Utah sits
The same service costs 11.2 times more in Tennessee 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· 48th of 51
$85.11
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.