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 $66.07 Median $2,951.21 Typical High $4,570.88 | Facility | None | $66.07 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $147.91 | Professional | None | $51.29 | $91.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $173.78 | Professional | None | $66.07 | $91.20 | $173.78 |
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 $138.04 Median $151.36 Typical High $204.17 | Facility | None | $138.04 | $151.36 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $158.49 | Professional | None | $63.10 | $109.65 | $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 $66.07 Median $141.25 Typical High $208.93 | Professional | None | $66.07 | $141.25 | $208.93 |
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 $51.29 Median $85.11 Typical High $162.18 | Professional | None | $51.29 | $85.11 | $162.18 |
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 $29.51 Median $37.15 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $11.75 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $56.23 Typical High $74.13 | Professional | 54 · Surgery only | $44.67 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $8.91 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.41 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.89 | $7.41 | $10.00 |
Where Utah sits
The same service costs 3.2 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· 44th of 51
$91.20
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.