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 $512.86 Median $3,162.28 Typical High $4,570.88 | Facility | None | $512.86 | $3,162.28 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | None | $426.58 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $562.34 | Professional | None | $446.68 | $457.09 | $562.34 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $302.00 | Professional | None | $218.78 | $251.19 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $676.08 | Professional | None | $575.44 | $602.56 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $660.69 | Professional | None | $380.19 | $562.34 | $660.69 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $1,122.02 | Professional | None | $316.23 | $524.81 | $1,122.02 |
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 $316.23 Median $371.54 Typical High $630.96 | Professional | None | $316.23 | $371.54 | $630.96 |
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 $213.80 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $316.23 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $51.29 |
Where Utah sits
The same service costs 4.9 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
$295
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.