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 $85.11 Median $2,951.21 Typical High $4,570.88 | Facility | None | $85.11 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $162.18 | Professional | None | $64.57 | $107.15 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $70.79 Typical High $72.44 | Facility | None | $67.61 | $70.79 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $169.82 | Professional | None | $83.18 | $109.65 | $169.82 |
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 $1,258.93 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 $81.28 Median $128.82 Typical High $158.49 | Professional | None | $81.28 | $128.82 | $158.49 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $186.21 | Professional | None | $69.18 | $117.49 | $186.21 |
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 $64.57 Median $95.50 Typical High $173.78 | Professional | None | $64.57 | $95.50 | $173.78 |
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 $38.02 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $38.02 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $22.39 | Professional | 53 · Discontinued | $15.14 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $67.61 Typical High $85.11 | Professional | 54 · Surgery only | $57.54 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $11.22 |
Where Utah sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 43rd of 51
$97.72
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.