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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $165.96 | Professional | None | $91.20 | $112.20 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,995.26 | $2,041.74 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $190.55 | Professional | None | $120.23 | $131.83 | $190.55 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $134.90 | Professional | None | $95.50 | $109.65 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $9,549.93 | Facility | None | $4,786.30 | $6,606.93 | $9,549.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $177.83 | Professional | None | $128.82 | $151.36 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $75.86 Median $151.36 Typical High $190.55 | Professional | None | $75.86 | $151.36 | $190.55 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,311.31 | $7,079.46 |
United Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $213.80 | Professional | None | $95.50 | $120.23 | $213.80 |
4 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 $46.77 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $46.77 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $19.05 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $11.22 |
Where Utah sits
The same service costs 7.9 times more in Kansas 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· 43rd of 51
$129
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.