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 $234.42 Median $2,884.03 Typical High $4,786.30 | Facility | None | $234.42 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $467.74 | Professional | None | $234.42 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $2,754.23 | Facility | None | $2,630.27 | $2,691.53 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $660.69 | Professional | None | $354.81 | $524.81 | $660.69 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Professional | None | $269.15 | $309.03 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,943.28 Median $10,232.93 Typical High $14,791.08 | Facility | None | $7,943.28 | $10,232.93 | $14,791.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $616.60 | Professional | None | $363.08 | $501.19 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $218.78 Median $524.81 Typical High $776.25 | Professional | None | $218.78 | $524.81 | $776.25 |
United Setting Facility Modifier None Typical Low $251.19 Median $6,760.83 Typical High $8,912.51 | Facility | None | $251.19 | $6,760.83 | $8,912.51 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $676.08 | Professional | None | $269.15 | $398.11 | $676.08 |
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 $117.49 Median $165.96 Typical High $208.93 | Professional | 52 · Reduced service | $117.49 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $66.07 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $48.98 Typical High $61.66 | Professional | 55 · Aftercare only | $34.67 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.11 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $33.11 | $41.69 |
Where Utah sits
The same service costs 3.9 times more in Alaska 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· 47th of 51
$380
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.