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 $28.18 Median $2,951.21 Typical High $4,570.88 | Facility | None | $28.18 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | None | $28.18 | $29.51 | $29.51 |
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 $23.44 Median $33.11 Typical High $43.65 | Professional | None | $23.44 | $33.11 | $43.65 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $66.07 Typical High $70.79 | Professional | None | $21.88 | $66.07 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | None | $33.88 | $38.02 | $42.66 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $52.48 | Professional | None | $33.11 | $40.74 | $52.48 |
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 $23.99 Median $28.18 Typical High $46.77 | Professional | None | $23.99 | $28.18 | $46.77 |
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 $14.13 Median $14.45 Typical High $14.79 | Professional | 52 · Reduced service | $14.13 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.62 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $21.88 Typical High $22.39 | Professional | 54 · Surgery only | $20.89 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.37 Typical High $4.47 | Professional | 55 · Aftercare only | $4.17 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.82 | $2.95 | $2.95 |
Where Utah sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 34th of 51
$34.67
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.