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 $70.79 Median $154.88 Typical High $4,570.88 | Facility | None | $70.79 | $154.88 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $154.88 | Professional | None | $52.48 | $75.86 | $154.88 |
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 $70.79 Median $95.50 Typical High $165.96 | Professional | None | $70.79 | $95.50 | $165.96 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | None | $48.98 | $56.23 | $69.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $588.84 | Facility | None | $323.59 | $407.38 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $131.83 | Professional | None | $64.57 | $100.00 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $169.82 | Professional | None | $64.57 | $109.65 | $169.82 |
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 $51.29 Median $79.43 Typical High $154.88 | Professional | None | $51.29 | $79.43 | $154.88 |
6 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 $33.11 Median $36.31 Typical High $77.62 | Professional | 52 · Reduced service | $33.11 | $36.31 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $30.90 | Professional | 53 · Discontinued | $13.18 | $14.79 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $54.95 Typical High $114.82 | Professional | 54 · Surgery only | $48.98 | $54.95 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.96 Typical High $22.91 | Professional | 55 · Aftercare only | $9.77 | $10.96 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $15.49 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $489.78 Median $616.60 Typical High $891.25 | Facility | 50 · Both sides | $489.78 | $616.60 | $891.25 |
Where Utah sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 49th of 51
$75.86
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.