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 $52.48 Median $54.95 Typical High $4,570.88 | Facility | None | $52.48 | $54.95 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $57.54 | Professional | None | $41.69 | $52.48 | $57.54 |
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 $32.36 Median $60.26 Typical High $63.10 | Professional | None | $32.36 | $60.26 | $63.10 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $114.82 Typical High $125.89 | Professional | None | $14.13 | $114.82 | $125.89 |
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 $23.44 Median $27.54 Typical High $32.36 | Professional | None | $23.44 | $27.54 | $32.36 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $48.98 | Professional | None | $22.91 | $30.20 | $48.98 |
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 $40.74 Typical High $57.54 | Professional | None | $23.99 | $40.74 | $57.54 |
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 $23.99 Median $26.30 Typical High $27.54 | Professional | 52 · Reduced service | $23.99 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.47 Typical High $10.96 | Professional | 53 · Discontinued | $9.55 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $39.81 Typical High $41.69 | Professional | 54 · Surgery only | $35.48 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.25 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.79 | $5.25 | $5.50 |
Where Utah sits
The same service costs 4.3 times more in Wyoming 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· 27th of 51
$42.66
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.