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 $275.42 Median $3,388.44 Typical High $6,025.60 | Facility | None | $275.42 | $3,388.44 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $275.42 | Professional | None | $208.93 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | None | $208.93 | $229.09 | $269.15 |
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 $281.84 Median $302.00 Typical High $331.13 | Professional | None | $281.84 | $302.00 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $331.13 | Professional | None | $190.55 | $281.84 | $331.13 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $426.58 | Professional | None | $158.49 | $263.03 | $426.58 |
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 $134.90 Median $186.21 Typical High $309.03 | Professional | None | $134.90 | $186.21 | $309.03 |
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 $104.71 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $27.54 | $27.54 |
Where Utah sits
The same service costs 4.5 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· 50th 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.