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 $213.80 Median $3,162.28 Typical High $4,570.88 | Facility | None | $213.80 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $213.80 | Professional | None | $162.18 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $199.53 | Facility | None | $190.55 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $331.13 | Professional | None | $204.17 | $234.42 | $331.13 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $169.82 | Professional | None | $120.23 | $138.04 | $169.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $912.01 | Facility | None | $501.19 | $630.96 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $302.00 | Professional | None | $223.87 | $263.03 | $302.00 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $331.13 | Professional | None | $131.83 | $257.04 | $331.13 |
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 $165.96 Median $208.93 Typical High $371.54 | Professional | None | $165.96 | $208.93 | $371.54 |
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 $81.28 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $123.03 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $24.55 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $21.38 | $21.38 |
Where Utah sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 49th of 51
$186
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.