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 $281.84 Median $3,162.28 Typical High $6,025.60 | Facility | None | $281.84 | $3,162.28 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | None | $213.80 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | None | $245.47 | $245.47 | $295.12 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $165.96 | Professional | None | $120.23 | $138.04 | $165.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $389.05 | Professional | None | $331.13 | $346.74 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $501.19 | Professional | None | $218.78 | $426.58 | $501.19 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $676.08 | Professional | None | $181.97 | $316.23 | $676.08 |
United Setting Facility Modifier None Typical Low $199.53 Median $2,951.21 Typical High $13,803.84 | Facility | None | $199.53 | $2,951.21 | $13,803.84 |
United Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $354.81 | Professional | None | $169.82 | $208.93 | $354.81 |
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 $120.23 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $28.18 |
Where Utah sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 51st of 51
$162
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.