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 $181.97 Median $2,951.21 Typical High $4,570.88 | Facility | None | $181.97 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $338.84 | Professional | None | $181.97 | $257.04 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $380.19 | Professional | None | $165.96 | $281.84 | $380.19 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | None | $165.96 | $199.53 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,344.23 | Facility | None | $1,288.25 | $1,621.81 | $2,344.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $371.54 Typical High $457.09 | Professional | None | $181.97 | $371.54 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $549.54 | Professional | None | $117.49 | $169.82 | $549.54 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $501.19 | Professional | None | $147.91 | $346.74 | $501.19 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,819.70 | $2,818.38 | $5,128.61 |
United Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $512.86 | Professional | None | $120.23 | $234.42 | $512.86 |
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 $91.20 Median $125.89 Typical High $169.82 | Professional | 52 · Reduced service | $91.20 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $50.12 Typical High $67.61 | Professional | 53 · Discontinued | $36.31 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.02 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.12 Typical High $33.88 | Professional | 56 · Pre-op care only | $18.20 | $25.12 | $33.88 |
Where Utah sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 42nd of 51
$214
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.