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 $158.49 Median $4,570.88 Typical High $9,772.37 | Facility | None | $158.49 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $257.04 | Professional | None | $128.82 | $158.49 | $257.04 |
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 $158.49 Median $169.82 Typical High $251.19 | Professional | None | $158.49 | $169.82 | $251.19 |
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 $165.96 Median $194.98 Typical High $229.09 | Professional | None | $165.96 | $194.98 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $245.47 | Professional | None | $97.72 | $194.98 | $245.47 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $4,168.69 Typical High $8,317.64 | Facility | None | $1,288.25 | $4,168.69 | $8,317.64 |
United Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $275.42 | Professional | None | $123.03 | $154.88 | $275.42 |
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 $60.26 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $15.85 | $15.85 |
Where Utah sits
The same service costs 10.7 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
$141
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.