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 $501.19 Median $4,570.88 Typical High $8,912.51 | Facility | None | $501.19 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $812.83 | Professional | None | $302.00 | $501.19 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $6,309.57 | Facility | None | $2,630.27 | $2,754.23 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $588.84 | Professional | None | $371.54 | $501.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $302.00 | Professional | None | $218.78 | $257.04 | $302.00 |
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 $389.05 Median $457.09 Typical High $630.96 | Professional | None | $389.05 | $457.09 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $6,309.57 | Facility | None | $3,801.89 | $3,801.89 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $588.84 | Professional | None | $275.42 | $457.09 | $588.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,073.80 | $8,317.64 |
United Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $660.69 | Professional | None | $288.40 | $398.11 | $660.69 |
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 $147.91 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $147.91 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $58.88 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $223.87 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $44.67 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $29.51 | $50.12 | $50.12 |
Where Utah sits
The same service costs 10.0 times more in Oklahoma 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· 50th of 51
$363
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.