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 $112.20 Median $158.49 Typical High $4,570.88 | Facility | None | $112.20 | $158.49 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $165.96 | Professional | None | $87.10 | $125.89 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $89.13 | Facility | None | $85.11 | $87.10 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $199.53 | Professional | None | $109.65 | $141.25 | $199.53 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $104.71 | Professional | None | $72.44 | $85.11 | $104.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,445.44 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $177.83 | Professional | None | $104.71 | $147.91 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $223.87 | Professional | None | $89.13 | $131.83 | $223.87 |
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 $85.11 Median $120.23 Typical High $213.80 | Professional | None | $85.11 | $120.23 | $213.80 |
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 $54.95 Median $58.88 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $22.39 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $89.13 Typical High $117.49 | Professional | 54 · Surgery only | $83.18 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $23.44 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $15.85 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,698.24 Median $2,187.76 Typical High $3,162.28 | Facility | 50 · Both sides | $1,698.24 | $2,187.76 | $3,162.28 |
Where Utah sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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
$112
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.