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 $158.49 Median $2,951.21 Typical High $4,570.88 | Facility | None | $158.49 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $281.84 | Professional | None | $123.03 | $181.97 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $117.49 | Facility | None | $109.65 | $114.82 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $288.40 | Professional | None | $154.88 | $194.98 | $288.40 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $173.78 | Professional | None | $120.23 | $141.25 | $173.78 |
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 $151.36 Median $223.87 Typical High $275.42 | Professional | None | $151.36 | $223.87 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $323.59 | Professional | None | $123.03 | $234.42 | $323.59 |
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 $123.03 Median $169.82 Typical High $302.00 | Professional | None | $123.03 | $169.82 | $302.00 |
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 $70.79 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $70.79 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $31.62 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $104.71 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $19.95 |
Where Utah sits
The same service costs 3.7 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· 46th of 51
$170
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.