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 $128.82 Median $2,951.21 Typical High $4,570.88 | Facility | None | $128.82 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $173.78 | Professional | None | $83.18 | $128.82 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $63.10 Typical High $63.10 | Facility | None | $58.88 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $144.54 | Professional | None | $91.20 | $109.65 | $144.54 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $100.00 | Professional | None | $72.44 | $85.11 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $891.25 | Facility | None | $478.63 | $602.56 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $151.36 | Professional | None | $70.79 | $117.49 | $151.36 |
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 $47.86 Median $56.23 Typical High $66.07 | Professional | None | $47.86 | $56.23 | $66.07 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $208.93 | Professional | None | $56.23 | $112.20 | $208.93 |
United Setting Facility Modifier None Typical Low $199.53 Median $1,023.29 Typical High $4,466.84 | Facility | None | $199.53 | $1,023.29 | $4,466.84 |
United Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $138.04 | Professional | None | $42.66 | $72.44 | $138.04 |
6 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 $47.86 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $47.86 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $19.05 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $70.79 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.50 Typical High $25.70 | Professional | 55 · Aftercare only | $14.45 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.55 | $12.88 | $17.38 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $707.95 Median $912.01 Typical High $1,318.26 | Facility | 50 · Both sides | $707.95 | $912.01 | $1,318.26 |
Where Utah sits
The same service costs 3.0 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· 31st of 51
$93.33
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.