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 $190.55 Median $2,951.21 Typical High $4,570.88 | Facility | None | $190.55 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $234.42 | Professional | None | $181.97 | $190.55 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $109.65 Typical High $112.20 | Facility | None | $102.33 | $109.65 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $295.12 | Professional | None | $186.21 | $229.09 | $295.12 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $208.93 | Professional | None | $144.54 | $169.82 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,630.27 | Facility | None | $1,258.93 | $1,778.28 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $263.03 | Professional | None | $177.83 | $223.87 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $109.65 Median $251.19 Typical High $363.08 | Professional | None | $109.65 | $251.19 | $363.08 |
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 $144.54 Median $181.97 Typical High $316.23 | Professional | None | $144.54 | $181.97 | $316.23 |
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 $91.20 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $134.90 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $23.44 |
Where Utah sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 36th of 51
$200
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.