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 $77.62 Median $109.65 Typical High $4,570.88 | Facility | None | $77.62 | $109.65 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $109.65 | Professional | None | $54.95 | $77.62 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $61.66 Typical High $63.10 | Facility | None | $57.54 | $61.66 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $144.54 | Professional | None | $75.86 | $104.71 | $144.54 |
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 $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 $70.79 Median $114.82 Typical High $141.25 | Professional | None | $70.79 | $114.82 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $181.97 | Professional | None | $46.77 | $117.49 | $181.97 |
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 $58.88 Median $87.10 Typical High $154.88 | Professional | None | $58.88 | $87.10 | $154.88 |
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 $33.11 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $33.11 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $16.60 Typical High $22.39 | Professional | 53 · Discontinued | $13.18 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $61.66 Typical High $83.18 | Professional | 54 · Surgery only | $50.12 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $10.00 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.61 | $8.32 | $10.96 |
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· 35th of 51
$95.50
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.