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 $60.26 Median $77.62 Typical High $4,570.88 | Facility | None | $60.26 | $77.62 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $81.28 | Professional | None | $60.26 | $69.18 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $89.13 | Professional | None | $53.70 | $75.86 | $89.13 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $67.61 | Professional | None | $48.98 | $56.23 | $67.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $389.05 | Facility | None | $204.17 | $263.03 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $100.00 | Professional | None | $61.66 | $85.11 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $120.23 | Professional | None | $57.54 | $91.20 | $120.23 |
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 $46.77 Median $63.10 Typical High $104.71 | Professional | None | $46.77 | $63.10 | $104.71 |
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 $30.20 Median $33.88 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $15.49 | Professional | 53 · Discontinued | $12.02 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $51.29 Typical High $57.54 | Professional | 54 · Surgery only | $45.71 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $11.48 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $7.76 |
Where Utah sits
The same service costs 3.6 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· 42nd of 51
$64.57
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.