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 $151.36 Median $3,162.28 Typical High $4,570.88 | Facility | None | $151.36 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | None | $117.49 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $457.09 Typical High $467.74 | Facility | None | $436.52 | $457.09 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | None | $134.90 | $134.90 | $213.80 |
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 $1,148.15 Median $1,412.54 Typical High $2,089.30 | Facility | None | $1,148.15 | $1,412.54 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $269.15 | Professional | None | $181.97 | $194.98 | $269.15 |
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 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $275.42 | Professional | None | $81.28 | $186.21 | $275.42 |
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 $107.15 Median $125.89 Typical High $234.42 | Professional | None | $107.15 | $125.89 | $234.42 |
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 $58.88 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $58.88 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $23.44 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $15.14 | $15.14 |
Where Utah sits
The same service costs 4.4 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· 47th of 51
$135
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.