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 $61.66 Median $97.72 Typical High $4,570.88 | Facility | None | $61.66 | $97.72 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $134.90 | Professional | None | $43.65 | $79.43 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $43.65 Typical High $44.67 | Facility | None | $41.69 | $43.65 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $117.49 | Professional | None | $61.66 | $85.11 | $117.49 |
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 $309.03 Median $416.87 Typical High $602.56 | Facility | None | $309.03 | $416.87 | $602.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $114.82 | Professional | None | $57.54 | $93.33 | $114.82 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $37.15 Median $95.50 Typical High $138.04 | Professional | None | $37.15 | $95.50 | $138.04 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $125.89 | Professional | None | $46.77 | $69.18 | $125.89 |
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 $26.92 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $26.92 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $13.49 Typical High $19.50 | Professional | 53 · Discontinued | $10.72 | $13.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $50.12 Typical High $74.13 | Professional | 54 · Surgery only | $39.81 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.00 Typical High $14.79 | Professional | 55 · Aftercare only | $8.13 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.37 | $6.76 | $9.77 |
Where Utah sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$67.61
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.