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 $154.88 Median $2,951.21 Typical High $4,570.88 | Facility | None | $154.88 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $199.53 | Professional | None | $109.65 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $117.49 Typical High $120.23 | Facility | None | $109.65 | $117.49 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $190.55 | Professional | None | $141.25 | $173.78 | $190.55 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $169.82 | Professional | None | $120.23 | $141.25 | $169.82 |
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 $169.82 Median $239.88 Typical High $288.40 | Professional | None | $169.82 | $239.88 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $162.18 | Professional | None | $114.82 | $138.04 | $162.18 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $354.81 | Professional | None | $131.83 | $223.87 | $354.81 |
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 $100.00 Median $134.90 Typical High $208.93 | Professional | None | $100.00 | $134.90 | $208.93 |
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 $77.62 Median $77.62 Typical High $97.72 | Professional | 52 · Reduced service | $77.62 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $30.90 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $147.91 | Professional | 54 · Surgery only | $114.82 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $19.95 |
Where Utah sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 37th of 51
$158
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.