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 $186.21 Median $3,162.28 Typical High $4,570.88 | Facility | None | $186.21 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $186.21 | Professional | None | $138.04 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $602.56 Typical High $602.56 | Facility | None | $575.44 | $602.56 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $275.42 | Professional | None | $169.82 | $181.97 | $275.42 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $295.12 | Professional | None | $30.20 | $44.67 | $295.12 |
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 $181.97 Median $218.78 Typical High $257.04 | Professional | None | $181.97 | $218.78 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $309.03 | Professional | None | $186.21 | $218.78 | $309.03 |
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 $131.83 Median $154.88 Typical High $302.00 | Professional | None | $131.83 | $154.88 | $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 $69.18 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $69.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $27.54 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $104.71 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $18.62 | $18.62 |
Where Utah sits
The same service costs 4.3 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· 37th of 51
$219
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.